人口老龄化及其对卫生保健总需求的影响:来自22个经合组织国家的经验证据。

Alfons Palangkaraya, Jongsay Yong
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引用次数: 65

摘要

最近的证据表明,年龄和卫生保健支出之间的关系并不像看起来那么简单。事实上,微观层面的研究发现,死亡时间,而不是老龄化,可能是发达国家卫生保健费用不断上升的主要驱动因素。不幸的是,宏观层面的证据不太清楚,往往取决于所使用的经验模型的规格。我们使用总需求框架来评估卫生支出更可能是由老龄化本身还是接近死亡驱动的。利用20世纪90年代上半叶来自22个经合组织国家的面板数据,我们发现,一旦考虑到接近死亡,人口老龄化与卫生支出呈负相关。这表明,老龄化对卫生支出增长的影响可能被夸大了,而生命末期医疗保健高成本的影响可能被低估了。对于后者,我们的研究结果强调了长期和临终关怀管理的重要性。扩大长期护理计划不仅可以改善患者的福利,还可以通过减少临终病人的住院治疗时间来降低护理成本。如果对接近生命末期的病人进行昂贵的医疗治疗能够得到控制,人口老龄化导致的保健支出增长不太可能成为一个最严重的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Population ageing and its implications on aggregate health care demand: empirical evidence from 22 OECD countries.

Recent evidence indicates that the relationship between age and health care expenditure is not as straightforward as it appears. In fact, micro-level studies find that time to death, rather than ageing, is possibly the main driver of the escalating health care costs in developed countries. Unfortunately, the evidence at the macro level is less clear and often depends on the specification of the empirical model used. We use an aggregate demand framework to assess whether health expenditure is more likely to be driven by ageing per se or proximity to death. Using panel data from 22 OECD countries from the first half of the 1990s, we find population ageing to be negatively correlated with health expenditure once proximity to death is accounted for. This suggests that the effects of ageing on health expenditure growth might be overstated while the effects of the high costs of medical care at the end of life are potentially underestimated. With respect to the latter, our finding highlights the importance of long-term and hospice care management. An expanded long-term care program may not only improve patient welfare, but also reduce costs of care by reducing the duration of hospital care for terminally ill patients. If expensive medical treatment for patients near the end of life can be controlled for, health expenditure growth resulting from population ageing is unlikely to present a most serious problem.

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