Public Finance Implications of Population Aging: 2005–50

Gragnolati, Michele; Jorgensen, Ole Hagen; Rocha, Romero; Fruttero, Anna

doi:10.1596/9780821388020_ch06

Cited by 5 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Brazil, an upper middle-income country, the population is becoming older at a much more rapid pace than it did in developed countries,8 and the Brazilian older population is estimated to increase more than three times from 2010 (~20 million) to 2050 (~65 million) 9. This demographic shift has a considerable impact on public expenses, especially those related to healthcare, since the Brazilian Unified Health System (known as ‘Sistema Único de Saúde’ SUS) is one of the largest public health systems in the world and covers approximately 200 million people with ‘free’ healthcare 10.…”

Section: Introductionmentioning

confidence: 99%

Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015

Dias

Barros

2019

J Epidemiol Community Health

View full text Add to dashboard Cite

BackgroundThe world’s population is progressively ageing, and this trend imposes several challenges to society and governments. The aim of this study was to investigate the burden generated by the hospitalisation of older (>60 years) compared with non-older population, as well as the epidemiology of these hospital admissions.MethodsUsing the Brazilian Unified Health System (known as ‘Sistema Único de Saúde’ (SUS)), an analysis of all hospital admissions of adult patients in the SUS from 2009 to 2015 was undertaken. The following indicators were used: hospital admission rate, intensive care unit (ICU) admission rate, average length of hospital and ICU stay, hospital mortality and average reimbursement per hospitalisation.ResultsA total of 61 958 959 admissions during the 7-year period, were analysed, encompassing 17 893 392 (28.9%) older patients. Elderly represent 15% (n=21 294 950) of the Brazilian adult population, but are responsible for 29% (n=17 893 392) of hospitalisations, 52% (n=1 731 299) of ICU admissions and 66% (n=1 885 291) of hospital mortality. Among the adults, elderly represents 39% of the total reimbursement made related to admission/hospitalisation. For 2009 to 2015, while the older population increased 27%, ICU admission rate increased 20%; the average length of ICU stay was 12% higher in 2015 (6.5 days) compared with 2009 (5.8 days); and the hospital mortality increased from 9.8% to 11.2%.ConclusionThese findings illustrate the current panorama of the burden due to hospitalisation of older people in the Brazilian public health system, and evidence the consolidation of the epidemiological transition toward the predominance of non-communicable diseases as the main cause of hospitalisation among the elderly in Brazil.

show abstract

Section: Introductionmentioning

confidence: 99%

Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015

Dias

Barros

2019

J Epidemiol Community Health

View full text Add to dashboard Cite

show abstract

“…For instance, Dynan, Skinner and Zeldes (2004) do not find evidence of dissaving among the elderly in the United States, and neither do Gragnolati et al (2011) for Brazil. Gandelman (2014a) observes that household heads above 60 display higher saving rates than those aged 40-49 in several Latin American countries.…”

Section: Literature Reviewmentioning

confidence: 89%

Understanding the Determinants of Household Saving: Micro Evidence for Latin America

Gasparini,

Bebczuk,

Amendolaggine

et al. 2015

View full text Add to dashboard Cite

This paper investigates the main patterns and drivers of the household saving rate in Latin America by assembling a broad dataset of official household surveys for 10 Latin American countries and 27 surveys covering selected years from the 1990s, 2000s and 2010s. Almost half of households display negative saving, which raises suspicions of income underreporting and/or consumption overreporting. The estimations highlight the overriding positive role of income in shaping saving decisions. Government transfers, remittances, self-employment, capitalization pension systems, access to financial services, urban location, and health and education expenses seem to diminish saving, whereas labor formality and homeownership have the opposite effect. In terms of policy implications, the drivers identified are either beyond the realm of direct government intervention or might be modified only in the long run. Moreover, some of these policies entail serious policy trade-offs, as they may boost saving at the expense of other worthy policy goals.

show abstract

“…Among developing countries in Latin America and the Caribbean, Brazil provides an interesting case to examine the issue of intermediate care, considering the extremely rapid pace at which its population is aging. Although in 2010 Brazil had a slightly lower portion of the population aged 60 years and over (10.2%) compared to countries such as Argentina (14.7%), Chile (13.2%) and Uruguay (18.4%), by 2050 it is expected to surpass all these countries on this indicator (29.3% versus 24.9%, 28.7%, and 27.4%, respectively) (Gragnolati et al, 2011).…”

Section: Prolonged Care In Brazilmentioning

confidence: 99%

The "Intermediate Care Hospital": Facility Bed-Based Rehabilitation for Elderly Patients

Mac Arthur,

Hendry

2017

View full text Add to dashboard Cite

Population aging and the growing burden of chronic disease are causing many countries to explore new options as they reorganize their health systems from acute care toward increased chronic care provision. There are several modalities to deliver recuperative intermediate care at a level between the hospital and primary care, but some patients will require a bed-based solution. For these individuals, inpatient non-acute facilities may provide superior outcomes at a lower cost than traditional care on a hospital ward. The international literature regarding this type of service reveals positive findings on provider and patient satisfaction, clinical outcomes, and cost-effectiveness. However, to achieve the best possible results, providers must establish and apply appropriate procedures for the identification of eligible patients, exercise rigorous protocols during their transfer, and ensure their comprehensive assessment and adhesion to a therapeutic plan managed by a multidisciplinary team. For developing countries considering the formulation of policies to promote the implementation of intermediate care facilities, Brazil's recent experience may offer a point of reference and some guidance, especially in terms of reconditioning small community hospitals with excess capacity for this purpose.

show abstract

Public Finance Implications of Population Aging: 2005–50

Cited by 5 publications

References 5 publications

Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015

Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015

Understanding the Determinants of Household Saving: Micro Evidence for Latin America

The "Intermediate Care Hospital": Facility Bed-Based Rehabilitation for Elderly Patients

Contact Info

Product

Resources

About