Longevity and health care expenditures: The real reasons older people spend more
Longevity and health care expenditures: The real reasons older people spend more
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DOI：
10.1093/geronb/58.1.s2
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发表时间：
2003-01-01
影响因子：
6.2
通讯作者：
Stearns, SC
中科院分区：
文献类型：
--
作者：
Yang, Z;Norton, EC;Stearns, SC
目标。在这项研究中，我们调查了年龄和死亡时间对老年医疗保险受益人的医疗支出的相对贡献。我们还分析了不同服务类型和支付者按年龄和死亡时间的支出模式的差异。我们对19921998医疗保险当前受益人调查成本和使用文件中的25,994名老年人进行了人月水平数据的图形化分析。老年人每月的保健支出随着年龄的增长而大幅增加，主要是因为死亡率随着年龄的增长而增加，而保健支出随着死亡的临近而增加。死亡时间是住院费用较高的主要原因，而老龄化是长期护理费用较高的主要原因。老年人绝对人数和寿命的增加都将增加未来的医疗保险支出。然而，由于支出集中在生命末期，而不是相对健康的额外年限，医疗保险受益人寿命延长导致的人均医疗保健支出预期增幅将低于预期。然而，由于其他潜在的考虑，如技术变化，后一个结论可能会被改变。
Objectives. In this study, we investigated the relative contributions of both age and time to death to health care expenditures for elderly Medicare beneficiaries. We also analyzed differences in expenditure patterns by age and time to death for various service types and payers.Methods. We conducted graphical analysis of person-month level data on 25,994 elderly persons from the 19921998 Medicare Current Beneficiary Survey Cost and Use files.Results. Monthly health care expenditures for elderly people increase substantially with age primarily because mortality rates increase with age and health care expenditures increase with closeness to death. Time to death is the main reason for higher inpatient care expenditures, whereas aging is the main reason for higher long-term care expenditure.Discussion. Both increases in the absolute number of elderly persons and in their longevity will increase future Medicare expenditures. Yet, the expected increase in per person health care expenditures caused by greater longevity of Medicare beneficiaries will be less than expected because of the concentration of expenditures at the end of life rather than during extra years of a relatively healthy life. The latter conclusion may be altered, however, because of other underlying considerations, such as technological change.