LONGEVITY AND ELDERLY HEALTH CARE EXPENDITURES

长寿和老年人医疗保健支出

• 批准号: 6372300
• 负责人: EDWARD C. NORTON
• 金额: $ 13.47万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-04-15 至 2003-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6372300
• 关键词: Medicare /Medicaid; aging; clinical research; death; disabling disease; epidemiology; extended care; functional ability; gender difference; health care cost /financing; health insurance; health services research tag; home health care; hospital utilization; human mortality; human old age (65+); human population study; human subject; longevity; managed care; mathematical model; nursing homes; widowhood

DESCRIPTION (Adapted from the Applicant's Abstract): Rapid aging by the United States population over the next several decades is expected to have profound effects on aggregate health care costs. Health care costs are expected to increase because babyboomers will swell the number of elderly, health care expenditures generally increase with age, the elderly are living longer, and technological change will increase the cost of medicine if it continues to increase at historical rates. However, four factors may mitigate the problem. Health care expenditures depend in part on time until death, with higher expenditures prior to death, so increased longevity may merely push expenditures further into the future. A growing percentage of Medicare beneficiaries are enrolling in Medicare managed care, which may slow the growth of expenditures. Male longevity has increased faster than female longevity, meaning that fewer elderly are widowed, which is a major risk factor for expensive long-term care. Finally, disability rates have been declining over at least the last decade. In the first part of the study the investigators will analyze per person annual health care expenditures as a function of age, time until death, their interaction, insurance (FFS vs. HMO), functional status (ADLs and IADLs), and demographics using seven years of the Medicare Current Beneficiary Survey. The analysis will focus on total health care expenditures by all payers for elderly Medicare beneficiaries, for both standard fee-for-service and HMO beneficiaries. They will also look at three specific types of expenditures: inpatient hospital care, home health, and nursing home. Payer types include Medicare, Medicaid, out-of-pocket, and other payers. In the second part of the study they will simulate future health care expenditures by combining our empirical results with available estimates of changes in the key parameters--mortality, functional status, other demographics, insurance, and technological change. The MCBS panel data will enable them to use their own estimates of the increase in managed care coverage and the decrease in disability rates, as well as other sources.

描述（改编自申请人的摘要）：美国的快速老龄化 预计未来几十年各州人口将产生深远影响 对总体医疗保健费用的影响。医疗保健费用预计 增加是因为婴儿潮一代将增加老年人的数量，医疗保健 支出通常随着年龄的增长而增加，老年人的寿命更长，并且 如果技术变革持续下去，药品成本将会增加 以历史速度增长。然而，有四个因素可以缓解这个问题。 医疗保健支出部分取决于死亡前的时间，较高的 死亡前的支出，因此寿命的延长可能只会推动 未来的支出。医疗保险的比例不断增加 受益人正在参加医疗保险管理式医疗，这可能会减缓增长 的支出。男性寿命增长快于女性寿命， 这意味着丧偶的老年人越来越少，这是丧偶的一个主要风险因素 昂贵的长期护理。最后，残疾率一直在下降 至少在过去十年。 在研究的第一部分，研究人员将分析每人每年的 医疗保健支出作为年龄、死亡时间、他们的健康状况的函数 互动、保险（FFS 与 HMO）、功能状态（ADL 和 IADL）以及 使用七年的医疗保险当前受益人调查进行人口统计。这 分析将重点关注所有老年人的医疗保健支出总额 标准服务费和 HMO 的 Medicare 受益人 受益人。他们还将关注三种具体类型的支出： 住院医院护理、家庭保健和疗养院。付款人类型包括 医疗保险、医疗补助、自付费用和其他付款人。 在研究的第二部分中，他们将模拟未来的医疗保健 通过将我们的实证结果与现有的估计相结合来计算支出 关键参数的变化——死亡率、功能状态等 人口统计、保险和技术变革。 MCBS 面板数据将 使他们能够使用自己对管理式医疗覆盖范围增加的估计 以及残疾率的下降以及其他来源。