IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v33y2024i4p748-763.html
   My bibliography  Save this article

A panel vector autoregression analysis for the dynamics of medical and long‐term care expenditures

Author

Listed:
  • Shinya Sugawara
  • Tsunehiro Ishihara
  • Susumu Kunisawa
  • Etsu Goto
  • Yuichi Imanaka

Abstract

Although medical and long‐term care expenditures for older adults are closely related, providing rigorous statistical analysis for their dynamic relationship is challenging. In this research, we propose a novel approach using the panel vector autoregression model to reveal the realized patterns of the interdependence. As an empirical application, we analyze monthly panel data on individuals in a city of Japan, where social insurance covers many formal services for long‐term care. Our estimation results indicate the existence of intertemporal transition from expensive acute medical care to reasonable at‐home medical care, then to at‐home long‐term care. Under this context, the enhancement of formal long‐term care sector in Japan might have played an important role in the suppression of the total care cost in spite for its rapid aging over the past 2 decades. Additionally, we find that daycare plays multiple roles in Japanese long‐term care, such as respite and rehabilitation, but there is no considerable transition from outpatient rehabilitation to daycare in the long‐term care sector.

Suggested Citation

  • Shinya Sugawara & Tsunehiro Ishihara & Susumu Kunisawa & Etsu Goto & Yuichi Imanaka, 2024. "A panel vector autoregression analysis for the dynamics of medical and long‐term care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 748-763, April.
    • Handle: RePEc:wly:hlthec:v:33:y:2024:i:4:p:748-763
    DOI: 10.1002/hec.4794
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4794
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.4794?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Fabio Canova & Matteo Ciccarelli, 2009. "Estimating Multicountry Var Models," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 50(3), pages 929-959, August.
    2. Michaud, Pierre-Carl & van Soest, Arthur, 2008. "Health and wealth of elderly couples: Causality tests using dynamic panel data models," Journal of Health Economics, Elsevier, vol. 27(5), pages 1312-1325, September.
    3. Holtz-Eakin, Douglas & Newey, Whitney & Rosen, Harvey S, 1988. "Estimating Vector Autoregressions with Panel Data," Econometrica, Econometric Society, vol. 56(6), pages 1371-1395, November.
    4. Andreas Werblow & Stefan Felder & Peter Zweifel, 2007. "Population ageing and health care expenditure: a school of ‘red herrings’?," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1109-1126, October.
    5. Crawford, Rowena & Stoye, George & Zaranko, Ben, 2021. "Long-term care spending and hospital use among the older population in England," Journal of Health Economics, Elsevier, vol. 78(C).
    6. Braun, Phillip A. & Mittnik, Stefan, 1993. "Misspecifications in vector autoregressions and their effects on impulse responses and variance decompositions," Journal of Econometrics, Elsevier, vol. 59(3), pages 319-341, October.
    7. Eric French & Jeremy Mccauley & Maria Aragon & Pieter Bakx & Martin Chalkley & Stacey H. Chen & Bent J. Christensen & Hongwei Chuang & Aurelie Côté-Sergent & Mariacristina de Nardi & Elliott Fan & Dam, 2017. "End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported," Post-Print halshs-01631529, HAL.
    8. Hideki Hashimoto & Hiromasa Horiguchi & Shinya Matsuda, 2010. "Micro Data Analysis of Medical and Long-Term Care Utilization Among the Elderly in Japan," IJERPH, MDPI, vol. 7(8), pages 1-16, July.
    9. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
    10. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496, September.
    11. Andreas Werblow & Stefan Felder & Peter Zweifel, 2007. "Population ageing and health care expenditure: a school of 'red herrings'?," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1109-1126.
    12. Claudine de Meijer & Pieter Bakx & Eddy van Doorslaer & Marc Koopmanschap, 2015. "Explaining Declining Rates of Institutional LTC Use in the Netherlands: A Decomposition Approach," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 18-31, March.
    13. Harris, Richard D. F. & Tzavalis, Elias, 1999. "Inference for unit roots in dynamic panels where the time dimension is fixed," Journal of Econometrics, Elsevier, vol. 91(2), pages 201-226, August.
    14. Silvia Balia & Rinaldo Brau, 2014. "A Country For Old Men? Long‐Term Home Care Utilization In Europe," Health Economics, John Wiley & Sons, Ltd., vol. 23(10), pages 1185-1212, October.
    15. Claudine Meijer & Pieter Bakx & Eddy Doorslaer & Marc Koopmanschap, 2015. "Explaining Declining Rates of Institutional LTC Use in the Netherlands: A Decomposition Approach," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 18-31, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Audrey Tanguy-Melac & Dorian Verboux & Laurence Pestel & Anne Fagot-Campagna & Philippe Tuppin & Christelle Gastaldi-Ménager, 2021. "Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1039-1052, September.
    2. Friedrich Breyer & Normann Lorenz & Thomas Niebel, 2015. "Health care expenditures and longevity: is there a Eubie Blake effect?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 95-112, January.
    3. Kasteridis, Panagiotis & Rice, Nigel & Santos, Rita, 2022. "Heterogeneity in end of life health care expenditure trajectory profiles," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 221-251.
    4. Joan Costa‐Font & Cristina Vilaplana‐Prieto, 2020. "‘More than one red herring'? Heterogeneous effects of ageing on health care utilisation," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 8-29, October.
    5. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    6. Fabio Pammolli & Francesco Porcelli & Francesco Vidoli & Monica Auteri & Guido Borà, 2017. "La spesa sanitaria delle Regioni in Italia - Saniregio2017," Working Papers CERM 01-2017, Competitività, Regole, Mercati (CERM).
    7. Kristopher J. Hult & Tomas J. Philipson, 2012. "Public Liabilities and Health Care Policy," NBER Working Papers 18571, National Bureau of Economic Research, Inc.
    8. Vincenzo Atella & Federico Belotti & Ludovico Carrino & Andrea Piano Mortari, 2017. "The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model," CEIS Research Paper 405, Tor Vergata University, CEIS, revised 08 May 2017.
    9. Ried Walter, 2007. "Medizinisch-technischer Fortschritt und altersspezifische Gesundheitsausgaben / Medical Progress and Age-specific Expenditure on Health Care," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 636-659, October.
    10. Colombier, Carsten, 2012. "Drivers of health care expenditure: Does Baumol's cost disease loom large?," FiFo Discussion Papers - Finanzwissenschaftliche Diskussionsbeiträge 12-5, University of Cologne, FiFo Institute for Public Economics.
    11. Howdon, Daniel & Rice, Nigel, 2018. "Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population," Journal of Health Economics, Elsevier, vol. 57(C), pages 60-74.
    12. Mauro Laudicella & Paolo Li Donni & Kim Rose Olsen & Dorte Gyrd‐Hansen, 2022. "Age, morbidity, or something else? A residual approach using microdata to measure the impact of technological progress on health care expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1184-1201, June.
    13. Keegan, Conor & Brick, Aoife & Bergin, Adele & Wren, Maev-Ann & Whyte, Richard & Henry, Edward, 2020. "Projections of expenditure for public hospitals in Ireland, 2018–2035, based on the Hippocrates Model," Research Series, Economic and Social Research Institute (ESRI), number RS117, August.
    14. Moore, Patrick V. & Bennett, Kathleen & Normand, Charles, 2017. "Counting the time lived, the time left or illness? Age, proximity to death, morbidity and prescribing expenditures," Social Science & Medicine, Elsevier, vol. 184(C), pages 1-14.
    15. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    16. Avalosse, Hervé & Denuit, Michel & Lucas, Nathalie, 2020. "Hospital inpatients costs dynamics at older ages: A frequency-severity approach," LIDAM Discussion Papers ISBA 2020027, Université catholique de Louvain, Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA).
    17. Jiang, Yunyun & Zhao, Tianhao & Zheng, Haitao, 2021. "Population aging and its effects on the gap of urban public health insurance in China," China Economic Review, Elsevier, vol. 68(C).
    18. Karlsson, Martin & Klohn, Florian, 2011. "Some notes on how to catch a red herring Ageing, time-to-death & care costs for older people in Sweden," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 77470, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    19. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2017. "Austria 2025 – Informal, Formal, or Both? Assessing the Drivers of Home Care Utilisation in Austria Using a Simultaneous Decision Framework," WIFO Studies, WIFO, number 59741, February.
    20. Saskia Groot & Irene Santi & Pieter Bakx & Bram Wouterse & Pieter Baal, 2023. "Informal Care Costs According to Age and Proximity to Death to Support Cost-Effectiveness Analyses," PharmacoEconomics, Springer, vol. 41(9), pages 1137-1149, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:33:y:2024:i:4:p:748-763. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.