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The European Journal of Health Economics
Erschienen in: The European Journal of Health Economics 5/2014

01.06.2014 | Original Paper

Testing the red herring hypothesis on an aggregated level: ageing, time-to-death and care costs for older people in Sweden

verfasst von: Martin Karlsson, Florian Klohn

Erschienen in: The European Journal of Health Economics | Ausgabe 5/2014

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Abstract

In this paper we test the ‘red herring’ hypothesis for expenditures on long-term care (LTC). The main contribution of this paper is to assess the ‘red herring’ hypothesis by using the probability of dying as a measure for time-to-death (TTD). In addition, we implement models that allow for age-specific TTD effects on LTC utilization as well as sex-specific effects. We also focus on total, institutional and domiciliary LTC separately. For our analysis we use high quality administrative data from Sweden. Our analysis is based on fixed effects estimates. We use our findings to project future LTC expenditures and show that, although TTD is a relevant predictor, age itself remains the main driver of LTC expenditures.
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Fußnoten
1
Data on LTC expenditures is available at http://​www.​scb.​se.
 
2
See "Appendix 1".
 
3
Data provided by Statistics Sweden can be downloaded at http://​www.​ssd.​scb.​se.
 
4
As already mentioned, some 4 % of total costs are covered by user charges. These are included in our cost variables so that these reflect the actual total costs of LTC for each individual in the publicly funded system.
 
5
For a detailed variable description see in "Appendix 2".
 
6
The pattern of lower probabilities of dying for higher age groups, as seen in Table 1, is simply a result of the variables being rescaled, as described above.
 
7
The 65+ population changes its municipality with a probability of around 0.011, a figure that is even lower (0.007) for the population aged 80+ [3].
 
8
A Hausman test supports the hypothesis that the consistency of a Random Effects estimate can be rejected.
 
9
We also estimate specifications where both contemporary and next year’s mortality are included. Wald tests do not reject the null hypothesis of the equality of both coefficients, suggesting that they control for the same mechanism influencing LTC costs. Therefore, we regard aggregation of both variables to be an appropriate way to control for the overall effect using just the aggregated variable—TTD65+.
 
10
Descriptive statistics are provided in "Appendix 3".
 
11
To evaluate to what extent the coefficients of sex-specific TTD are reliable and not a result of colinearity due to the inclusion of many TTD variables, we run single regressions with just one specific TTD variable included. A reason for such a problem could be comorbidity of very old people, which would not allow identifying the TTD effects separately for both sexes. However, these estimates prove the findings for the complete specification being very similar both in terms of economic relevance and statistical significance.
 
12
The formula for cost increase per life year is provided in “Appendix 6”.
 
13
The pattern is similar if we use sex-specific estimates ("Appendices 7, 8").
 
Literatur
1.
Bech, M., Christiansen, T., Khoman, E., Lauridsen, J., Weale, M.: Ageing and health care expenditure in EU-15. Eur. J. Health Econ. 12(5), 469–478 (2011)PubMedCrossRef
2.
3.
SCB-Statistiska Centralbyrån: Tabeller över sveriges befolkning 2006. SCB-Tryck, Örebro (2009)
4.
Colombo, F., Ana, L., Jérôme, M., Frits, T.: OECD Health Policy Studies Help Wanted? Providing and Paying for Long-Term Care. Organization for Economic (2011)
5.
de Meijer, C., Koopmanschap, M., Uva, T.B., van Doorslaer, E.: Determinants of long-term care spending: age, time to death or disability? J. Health Econ. 30(2), 425–438 (2011)
6.
Felder, S., Werblow, A., Zweifel, P.: Do red herrings swim in circles? controlling for the endogeneity of time to death. J. Health Econ. 29(2), 205–212 (2010)PubMedCrossRef
7.
Forma, L., Rissanen, P., Noro, A., Raitanen, J., Jylhä, M.: Health and social service use among old people in the last 2 years of life. Eur. J. Ageing 4(3), 145–154 (2007)CrossRef
8.
Fukushima, N., Adami, J., Palme, M.: The Long-Term Care System for the Elderly in Sweden. Technical report, ENEPRI Research Report (2010)
9.
Getzen, T.: Health care is an individual necessity and a national luxury: applying multilevel decision models to the analysis of health care expenditures. J. Health Econ. 19(2), 259–270 (2000)PubMedCrossRef
10.
11.
Karlsson, M., Iversen, T., Øien, H.: Scandinavian Long-Term Care Financing. Technical report, Oslo University, Health Economics Research Programme (2010)
12.
Karlsson, M., Klohn, F.: Ageing, health and disability—an economic perspective. In: From Grey to Silver. Springer, Berlin, Heidelberg, pp. 51–67 (2011)
13.
Larsson, K., Kåreholt, I., Thorslund, M.: Care utilisation in the last years of life in relation to age and time to death: results from a Swedish urban population of the oldest old. Eur. J. Ageing 5(4), 349–357 (2008)CrossRef
14.
Meier, V., Werding, M.: Ageing and the welfare state: securing sustainability. Oxf. Rev. Econ. Policy 26(4), 655–673 (2010)CrossRef
15.
16.
Palangkaraya, A., Yong, J.: Population ageing and its implications on aggregate health care demand: empirical evidence from 22 OECD countries. Int. J. Health Care Financ. Econ. 9(4), 391–402 (2009)CrossRef
17.
Paraponaris, A., Davin, B., Verger, P.: Formal and informal care for disabled elderly living in the community: an appraisal of French care composition and costs. Eur. J. Health Econ. 1–10 (2012)
18.
Payne, G., Laporte, A., Deber, R., Coyte, P.: Counting backward to health care’s future: using time-to-death modeling to identify changes in end-of-life morbidity and the impact of aging on health care expenditures. Milbank Q. 85(2), 213–257 (2007)PubMedCentralPubMedCrossRef
19.
Socialstyrelsen: Äldre—Vård och omsorg 2007. Socialstyrelsen, Sweden (2008)
20.
United Nations: World Population Prospects: The 2008 Revision. United Nations (2008)
21.
van Baal, P.H., Wong, A.: Time to death and the forecasting of macro-level health care expenditures: some further considerations. J. Health Econ. 31(6), 876–887 (2012)
22.
Werblow, A., Felder, S., Zweifel, P.: Population ageing and health care expenditure: a school of red herrings? Health Econ. 16(10), 1109–1126 (2007)PubMedCrossRef
23.
Wilmoth, J., Andreev, K., Jdanov, D., Glei, D.: Methods Protocol for the Human Mortality Database. University of California, Berkeley, and Max Planck Institute for Demographic Research, Rostock. URL: http://​mortality.​org [version 31/05/2007] (2007)
24.
Wong, A., van Baal, P., Boshuizen, H., Polder, J.: Exploring the influence of proximity to death on disease-specific hospital expenditures: a carpaccio of red herrings. Health Econ. 20(4), 379–400 (2011)PubMedCrossRef
25.
Zweifel, P., Felder, S., Meiers, M.: Ageing of population and health care expenditure: a red herring. Health Econ. 8(6), 485–496 (1999)PubMedCrossRef
Metadaten
Titel
Testing the red herring hypothesis on an aggregated level: ageing, time-to-death and care costs for older people in Sweden
verfasst von
Martin Karlsson
Florian Klohn
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
The European Journal of Health Economics / Ausgabe 5/2014
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-013-0493-0

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