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Determinants of health-care costs in the oldest-old in Germany

Author

Listed:
  • Brettschneider, Christian
  • Hajek, Andre
  • Röhr, Susanne
  • Fuchs, Angela
  • Weeg, Dagmar
  • Mamone, Silke
  • Werle, Jochen
  • Heser, Kathrin
  • Mallon, Tina
  • Stein, Janine
  • Pentzek, Michael
  • Bickel, Horst
  • Wiese, Birgitt
  • Weyerer, Siegfried
  • Wagner, Michael
  • van den Bussche, Hendrik
  • Maier, Wolfgang
  • Scherer, Martin
  • Riedel-Heller, Steffi G
  • König, Hans-Helmut

Abstract

The population of the oldest old often suffers from ill health and causes high health care costs. Yet, this group has rarely been examined. We investigated determinants of health care costs in the population of oldest olds (≥85 years) in Germany by analyzing data from a large multi-center, prospective cohort study (n = 856). Health care costs per capita amounted to 8,023€ (SD: 9637€) in a 6-month period. Costs per capita were highest for inpatient services and nursing care services. Frailty was the dominating factor. In comparison to non-frail people, all degrees of frailty were associated with a similar increase of informal care costs. Morbidity was also associated with increased total costs. Social isolation showed various associations. We conclude that frailty, morbidity and social isolation are the most important factors among the oldest old. As frailty is a common but complex phenomenon in the oldest-old, cost-effective strategies for its management are needed.

Suggested Citation

  • Brettschneider, Christian & Hajek, Andre & Röhr, Susanne & Fuchs, Angela & Weeg, Dagmar & Mamone, Silke & Werle, Jochen & Heser, Kathrin & Mallon, Tina & Stein, Janine & Pentzek, Michael & Bickel, Hor, 2019. "Determinants of health-care costs in the oldest-old in Germany," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    • Handle: RePEc:eee:joecag:v:14:y:2019:i:c:s2212828x18301282
    DOI: 10.1016/j.jeoa.2019.100200
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    References listed on IDEAS

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    1. Matthias Eckardt & Christian Brettschneider & Hendrik van den Bussche & Hans‐Helmut König & MultiCare Study Group, 2017. "Analysis of Health Care Costs in Elderly Patients with Multiple Chronic Conditions Using a Finite Mixture of Generalized Linear Models," Health Economics, John Wiley & Sons, Ltd., vol. 26(5), pages 582-599, May.
    2. Sarah Karlsberg Schaffer, 2015. "The Effect of Free Personal Care for the Elderly on Informal Caregiving," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 104-117, March.
    3. Nicolas Sirven & Thomas Rapp, 2017. "The cost of frailty in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 243-253, March.
    4. 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.
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    1. Andrea E Zuelke & Steffi G Riedel-Heller & Felix Wittmann & Alexander Pabst & Susanne Roehr & Melanie Luppa, 2021. "Gender-specific design and effectiveness of non-pharmacological interventions against cognitive decline and dementia–protocol for a systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-10, August.

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