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Ageing and healthcare expenditures: Exploring the role of individual health status

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  • Marc Carreras
  • Pere Ibern
  • José María Inoriza

Abstract

In 1999, Zweifel, Felder, and Meiers questioned conventional wisdom on ageing and healthcare expenditure (HCE). According to these authors, the positive association between age and HCE is due to an increasing age‐specific mortality and the high cost of dying. After a weighty academic debate, a new consensus was reached on the importance of proximity to death when analysing HCE. Nevertheless, the influence of individual health status remains unknown. The objective of our study is to analyse the influence individual health status has on HCE, when compared to proximity to death and demographic effects and considering a comprehensive view of healthcare services and costs. We examined data concerning different HCE components of N = 61,473 persons aged 30 to 95 years old. Using 2‐part models, we analysed the probability of use and positive HCE. Regardless of the specific group of healthcare services, HCE at the end of life depends mainly on the individual health status. Proximity to death approximates individual morbidity when it is excluded from the model. The inclusion of morbidity generally improves the goodness of fit. These results provide implications for the analysis of ageing population and its impact on HCE that should be taken into account.

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  • 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.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:5:p:865-876
    DOI: 10.1002/hec.3635
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    3. Davillas, Apostolos & Jones, Andrew M., 2025. "Biological age and predicting future health care utilisation," Journal of Health Economics, Elsevier, vol. 99(C).
    4. Davillas, Apostolos & M. Jones, Andrew, 2024. "Biological age and predicting future health care utilisation," ISER Working Paper Series 2024-03, Institute for Social and Economic Research.
    5. 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).
    6. Davillas, Apostolos & Pudney, Stephen, 2019. "Baseline health and public healthcare costs five years on: a predictive analysis using biomarker data in a prospective household panel," ISER Working Paper Series 2019-01, Institute for Social and Economic Research.
    7. Maynou, Laia & Street, Andrew & García−Altés, Anna, 2023. "Living longer in declining health: Factors driving healthcare costs among older people," Social Science & Medicine, Elsevier, vol. 327(C).
    8. Davillas, Apostolos & Jones, Andrew M., 2025. "Biological age and predicting future health care utilisation," Journal of Health Economics, Elsevier, vol. 99(C).
    9. V. P. Sanitha & J. K. Parida & I. C. Awasthi, 2019. "Health Conditions, Medication and Hospitalisation Preferences of Elderly in Kerala," Indian Journal of Human Development, , vol. 13(3), pages 308-324, December.
    10. Santos, João Vasco & Martins, Filipa Santos & Pestana, Joana & Souza, Júlio & Freitas, Alberto & Cylus, Jonathan, 2023. "Should we adjust health expenditure for age structure on health systems efficiency? A worldwide analysis," LSE Research Online Documents on Economics 118298, London School of Economics and Political Science, LSE Library.
    11. Lemye Zehirlioglu & Hatice Mert & Dilek Sezgin & Ebru Özpelit, 2020. "Cardiovascular Risk, Risk Knowledge, and Related Factors in Patients With Type 2 Diabetes," Clinical Nursing Research, , vol. 29(5), pages 322-330, June.
    12. Calciolari, Stefano & Luini, Cecilia, 2023. "Effects of the bio-psycho-social frailty dimensions on healthcare utilisation among elderly in Europe: A cross-country longitudinal analysis," Social Science & Medicine, Elsevier, vol. 339(C).
    13. Anna Kollerup & Jakob Kjellberg & Rikke Ibsen, 2022. "Ageing and health care expenditures: the importance of age per se, steepening of the individual-level expenditure curve, and the role of morbidity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1121-1149, September.
    14. Jonas Krämer & Jonas Schreyögg, 2019. "Demand-side determinants of rising hospital admissions in Germany: the role of ageing," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 715-728, July.
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    16. Viktor von Wyl, 2019. "Proximity to death and health care expenditure increase revisited: A 15-year panel analysis of elderly persons," Health Economics Review, Springer, vol. 9(1), pages 1-16, December.

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