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The impact of long-term care service on total lifetime medical expenditure among older adults with dementia

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  • Moon, Sungje
  • Park, Hee Jung
  • Sohn, Minsung

Abstract

Along with the rapid increase in older adult population in South Korea, the management of dementia is becoming important. Higher dementia prevalence inevitably leads to an excessive burden on medical expenditure throughout one's life, so the catastrophic health expenditure for dementia should be protected in the aspect of both nation and family. Therefore, this study attempted to estimate the lifetime medical expenditures (LE) of older adults with dementia, and confirmed if the long-term care insurance (LTCI) is effective in reducing their medical expenses. The study analyzed LE of adults, aged over 70 years, using a cohort database and simulated the total LE per capita. In order to compare the differences in LE due to dementia, propensity score matching (PSM) was performed. As of 2015, the total LE per capita for older adults with dementia and without dementia was estimated to be 76,973 thousand won ($65,427) and 31,105 thousand won ($26,439). Older adults with dementia had 2.4 times more expenditure than those without dementia. In particular, the LE per capita for hospitalization of dementia patients was 63,945 thousand won ($54,353), which was about 5 times higher than LE per capita for outpatient treatment. In addition, as a result of confirming the political effectiveness of LTCI, the LE for older adults with dementia, who had not used the long-term care service (LTCS), was estimated to be about 85,769 thousand won ($72,904). Conversely, LTCS users were estimated to spend 70,487 thousand won ($59,914), which means that LTCS non-users spent about 22% more on total LE than LTCS users. Non-users spent about half of their LE after the age of 80. Based on these findings, this study confirmed that the LTCI system had the desired effect of reducing the total LE for older adults with dementia.

Suggested Citation

  • Moon, Sungje & Park, Hee Jung & Sohn, Minsung, 2021. "The impact of long-term care service on total lifetime medical expenditure among older adults with dementia," Social Science & Medicine, Elsevier, vol. 280(C).
  • Handle: RePEc:eee:socmed:v:280:y:2021:i:c:s0277953621004044
    DOI: 10.1016/j.socscimed.2021.114072
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    References listed on IDEAS

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    1. Marc Carreras & Pere Ibern & José María Inoriza, 2018. "Ageing and healthcare expenditures: Exploring the role of individual health status," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 865-876, May.
    2. Rajeev H. Dehejia & Sadek Wahba, 2002. "Propensity Score-Matching Methods For Nonexperimental Causal Studies," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 151-161, February.
    3. Julien Forder, 2009. "Long‐term care and hospital utilisation by older people: an analysis of substitution rates," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1322-1338, November.
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    1. Eneja Drobež & David Bogataj, 2022. "Legal Aspects of Social Infrastructure for Housing and Care for the Elderly—The Case of Slovenia," Laws, MDPI, vol. 11(2), pages 1-19, February.

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