ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2014
Population ageing and healthcare expenditure projections: new evidence from a time to death approach.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Competing Demographic Drivers of Hospital Expenditures: Coexistence of the Red Herring and the Steepening Effects.Health economics · 2026Article
- Inclusion of older adults in UK clinical research-the National Institute for Health and Care Research Year of Birth Project.Age and ageing · 2026Article
- Ageing populations: new challenges in longevity.BMC public health · 2025Article
- Age, morbidity, and time to death: End-of-life expenditures on health care for the young-old population.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- The impact of ageing, socio-economic differences and the evolution of morbidity on future health expenditure - a dynamic microsimulation.BMC health services research · 2025Article
- Implications for household health expenditure in China's ageing population: based on Red Herring hypothesis.BMC public health · 2024Article
- Variation in End-of-Life Trajectories in Persons Aged 70 Years and Older, Sweden, 2018‒2020.American journal of public health · 2023Article
- A Model to Compare International Hospital Bed Numbers, including a Case Study on the Role of Indigenous People on Acute 'Occupied' Bed Demand in Australian States.International journal of environmental research and public health · 2022Article
- Article
- Hospital Expenditure at the End-of-Life: A Time-to-Death Approach.International journal of health policy and management · 2022Article
- The 'Red Herring' Hypothesis: Some Theory and New Evidence.Healthcare (Basel, Switzerland) · 2022Article
- Emergency hospital admissions among older adults living alone in the community.BMC health services research · 2021Article
- Comparison of Japanese Centenarians' and Noncentenarians' Medical Expenditures in the Last Year of Life.JAMA network open · 2021Article
- 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 : HEPAC : health economics in prevention and care · 2021Article
- Socioeconomic differences in healthcare expenditure and utilization in The Netherlands.BMC health services research · 2021Article
- Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis.Health economics review · 2020Article
- Health care expenditure and environmental pollution: a cross-country comparison across different income groups.Environmental science and pollution research international · 2020Article
- Comparing the prognostic value of geriatric health indicators: a population-based study.BMC medicine · 2019Article
- The Last Year Before Graft Failure Negatively Impacts Economic Outcomes and is Associated With Greater Healthcare Resource Utilization Compared With Previous Years in the United Kingdom: Results of a Retrospective Observational Study.Transplantation direct · 2019Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundHealth care expenditure (HCE) is not distributed evenly over a person's life course. How much is spent on the elderly is important as they are a population group that is increasing in size. However other factors, such as death-related costs that are known to be high, need be considered as well in any expenditure projections and budget planning decisions.
objectiveThis article analyses, for the first time in Scotland, how expenditure projections for acute inpatient care are influenced when applying two different analytical approaches: (1) accounting for healthcare (HC) spending at the end of life and (2) accounting for demographic changes only. The association between socioeconomic status and HC utilisation and costs at the end of life is also estimated.
methodsA representative, longitudinal data set is used. Survival analysis is employed to allow inclusion of surviving sample members. Cost estimates are derived from a two-part regression model. Future population estimates were obtained for both methods and multiplied separately by cost estimates.
resultsTime to death (TTD), age at death and the interaction between these two have a significant effect on HC costs. As individuals approach death, those living in more deprived areas are less likely to be hospitalised than those individuals living in the more affluent areas, although this does not translate into incurring statistically significant higher costs. Projected HCE for acute inpatient care for the year 2028 was approximately 7% higher under the demographic approach as compared to a TTD approach.
conclusionThe analysis showed that if death is postponed into older ages, HCE (and HC budgets) would not increase to the same extent if these factors were ignored. Such factors would be ignored if the population that is in their last year(s) of life were not taken into consideration when obtaining cost estimates.
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