The effect of population aging on health expenditure growth

A critical review

C. de Meijer, B. Wouterse, J.J. Polder, M. Koopmanschap

Research output: Contribution to journalReview articleScientificpeer-review

Abstract

Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in Western countries by combining insights from epidemiological and health economics research. Based on a conceptual model of health care use, we first review evidence on the relationship between age and health expenditures to provide insight into the direct effect of aging on health expenditure growth. Second, we discuss the interaction between aging and the main societal drivers of health expenditures. Aging most likely influences growth in health expenditures indirectly, through its influence on these societal factors. The literature shows that the direct effect of aging depends strongly on underlying health and disability. Commonly used approximations of health, like age or mortality, insufficiently capture complex dynamics in health. Population aging moderately increases expenditures on acute care and strongly increases expenditures on long-term care. The evidence further shows that the most important driver of health expenditure growth, medical technology, interacts strongly with age and health, i.e., population aging reinforces the influence of medical technology on health expenditure growth and vice versa. We therefore conclude that population aging will remain in the centre of policy debate. Further research should focus on the changes in health that explain the effect of longevity gains on health expenditures, and on the interactions between aging and other societal factors driving expenditure growth.
Keywords: Population aging, Morbidity, Technology, Health expenditures, Acute care, Long-term care
Original languageEnglish
Pages (from-to)353-361
JournalEuropean Journal of Aging
Volume10
Issue number4
DOIs
Publication statusPublished - 2013

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expenditures
health
Long-Term Care
medical technology
driver
economic research
interaction
research focus
morbidity
evidence
Delivery of Health Care
mortality
disability
health care

Cite this

de Meijer, C. ; Wouterse, B. ; Polder, J.J. ; Koopmanschap, M. / The effect of population aging on health expenditure growth : A critical review. In: European Journal of Aging. 2013 ; Vol. 10, No. 4. pp. 353-361.
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title = "The effect of population aging on health expenditure growth: A critical review",
abstract = "Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in Western countries by combining insights from epidemiological and health economics research. Based on a conceptual model of health care use, we first review evidence on the relationship between age and health expenditures to provide insight into the direct effect of aging on health expenditure growth. Second, we discuss the interaction between aging and the main societal drivers of health expenditures. Aging most likely influences growth in health expenditures indirectly, through its influence on these societal factors. The literature shows that the direct effect of aging depends strongly on underlying health and disability. Commonly used approximations of health, like age or mortality, insufficiently capture complex dynamics in health. Population aging moderately increases expenditures on acute care and strongly increases expenditures on long-term care. The evidence further shows that the most important driver of health expenditure growth, medical technology, interacts strongly with age and health, i.e., population aging reinforces the influence of medical technology on health expenditure growth and vice versa. We therefore conclude that population aging will remain in the centre of policy debate. Further research should focus on the changes in health that explain the effect of longevity gains on health expenditures, and on the interactions between aging and other societal factors driving expenditure growth.Keywords: Population aging, Morbidity, Technology, Health expenditures, Acute care, Long-term care",
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The effect of population aging on health expenditure growth : A critical review. / de Meijer, C.; Wouterse, B.; Polder, J.J.; Koopmanschap, M.

In: European Journal of Aging, Vol. 10, No. 4, 2013, p. 353-361.

Research output: Contribution to journalReview articleScientificpeer-review

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T1 - The effect of population aging on health expenditure growth

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AU - de Meijer, C.

AU - Wouterse, B.

AU - Polder, J.J.

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AB - Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in Western countries by combining insights from epidemiological and health economics research. Based on a conceptual model of health care use, we first review evidence on the relationship between age and health expenditures to provide insight into the direct effect of aging on health expenditure growth. Second, we discuss the interaction between aging and the main societal drivers of health expenditures. Aging most likely influences growth in health expenditures indirectly, through its influence on these societal factors. The literature shows that the direct effect of aging depends strongly on underlying health and disability. Commonly used approximations of health, like age or mortality, insufficiently capture complex dynamics in health. Population aging moderately increases expenditures on acute care and strongly increases expenditures on long-term care. The evidence further shows that the most important driver of health expenditure growth, medical technology, interacts strongly with age and health, i.e., population aging reinforces the influence of medical technology on health expenditure growth and vice versa. We therefore conclude that population aging will remain in the centre of policy debate. Further research should focus on the changes in health that explain the effect of longevity gains on health expenditures, and on the interactions between aging and other societal factors driving expenditure growth.Keywords: Population aging, Morbidity, Technology, Health expenditures, Acute care, Long-term care

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