Health, Life Expectancy, and Health Care Spending among the Elderly

Lubitz, James; Cai, Liming; Kramarow, Ellen A.; Lentzner, Harold R.

doi:10.1056/nejmsa020614

Cited by 429 publications

(299 citation statements)

References 24 publications

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“…It is very unlikely that any individual health or functional condition will be the sole predictor of mortality (Lubitz et al 2003). It is therefore useful to determine which factors are the most important predictors of mortality.…”

Section: Introductionmentioning

confidence: 99%

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Hirani

Naganathan

Blyth

et al. 2014

AGE

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This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005)(2006)(2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of mortality included in the final model (p<0.05) were older age, body mass index<20 kg m 2 , high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong nondrinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it AGE (2014) was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a younger population, including high blood pressure, hypercholesterolaemia, overweight and obesity and diabetes, were not independent predictors of mortality in this population of older men.

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Section: Introductionmentioning

confidence: 99%

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Hirani

Naganathan

Blyth

et al. 2014

AGE

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“…The conclusions and policy implications are provided at the end of this paper. 11 Lubitz et al (2003). 12 Stearns and Norton (2004).…”

Section: Introductionmentioning

confidence: 99%

Re-estimating the Demographic Impact on Health Care Expenditure: Evidence from Taiwan

Shiu

Chiu

2008

Geneva Pap Risk Insur Issues Pract

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Unlike prior studies, we consider not only population ageing but also life expectancy as demographic variables that may explain the variations in health care expenditure. Cointegration techniques are employed to re-examine the effect of demographic changes on the Taiwan health care expenditure from 1960 to 2006. We find that the Taiwan health care expenditure, income, population ageing, life expectancy and the number of practicing physicians have statistically significant and long-run economic relationships. All variables have a positive impact on health care expenditure besides life expenditure. Our empirical results support the compression of morbidity hypothesis, suggesting that older people become healthier than in the past and that health care expenditure would decrease with life expectancy. Several implications for policymaking and future research are offered.

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“…The health care dependency ratio is defined as the number of high-cost users of health care divided by the population 20 to 64. The majority of health expenditures are directed toward high-cost users -those in their final decade of life and most especially their final year of life (MILLER, 2001;LUBITZ et al, 2003;MCGRAIL et al, 2000). Accordingly, our health care dependency ratio measures the relative size of the high cost user population defined as the number of people who will die within a decade.…”

Section: The Projection Modelmentioning

confidence: 99%

The fiscal impact of population aging in Brazil: 2005-2050

Miller¹,

Castanheira²

2013

Rev. bras. estud. popul.

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In this paper, we estimate the fiscal impact on population aging in Brazil from 2005 through 2050. We focus on three key areas of public spending: education, pensions, and health care. Our projections are based on a simple model in which aggregate public expenditures are driven by changes in the age structure of the population as well as by changes in the average public benefits received per age. We assess the likely increases in public spending over the coming decades, contrasting the divergent trends in public spending on education, pensions, and health care. We also assess the magnitude of these changes in terms of growth in spending relative to GDP annually through 2050 and estimate the present value of the increase in spending. We find that changing population age structure will lead to increasing cost pressures in health care and especially in pensions. Our projections show that beginning around 2015, public spending will begin a sustained and rapid increase lasting several decades rising from 18% of GDP to reach 27% of GDP by 2050. The needs for increased investment in students will compete against those for sustaining pension benefits and facing increasing demands for health care. In particular, our projections show that an ambitious educational reform aimed at reaching the OECD level of investment per youth within a decade would amount to only about one fourth of the projected cost increases in public health and pension programs.

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Health, Life Expectancy, and Health Care Spending among the Elderly

Cited by 429 publications

References 24 publications

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Re-estimating the Demographic Impact on Health Care Expenditure: Evidence from Taiwan

The fiscal impact of population aging in Brazil: 2005-2050

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