LONGEVITY AND ELDERLY HEALTH CARE EXPENDITURES

描述(改编自申请者摘要)：美国快速老化 预计未来几十年各州人口将有深远的 对医疗保健总成本的影响。医疗保健成本预计将 增加，因为婴儿潮一代会增加老年人的数量，医疗保健 支出通常会随着年龄的增长而增加，老年人的寿命更长，而且 如果技术变革继续下去，将增加药品成本 按历史比率增长。然而，有四个因素可能会缓解这个问题。 医疗保健支出在一定程度上取决于直到死亡的时间， 死亡前的支出，因此延长寿命可能只会推动 未来更远的支出。医疗保险的比例越来越高 受益人正在参加联邦医疗保险管理的医疗保健，这可能会减缓增长 支出的比例。男性寿命比女性寿命增长得更快， 这意味着更少的老年人丧偶，这是 昂贵的长期护理。最后，伤残率一直在下降。 至少在过去的十年里。 在研究的第一部分，调查人员将分析每人每年 医疗保健支出与年龄、死亡时间、年龄和年龄的关系 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的人口统计学。这个 分析的重点将是所有老年人的医疗保健总支出 医疗保险受益人，包括标准服务费和医疗保健组织 受益人。他们还将研究三种具体类型的支出： 住院护理、家庭健康和疗养院。付款人类型包括 医疗保险、医疗补助、自付和其他支付者。 在研究的第二部分，他们将模拟未来的医疗保健 通过将我们的经验结果与可用的估计数相结合来进行支出 关键参数的变化--死亡率、功能状态、其他 人口统计、保险和技术变革。MCBS面板数据将 使他们能够使用他们自己对管理医疗覆盖范围增加的估计 以及残疾比率的下降，以及其他来源。

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.