The Concentration of Hospital‐Based Medical Spending: Evidence from Canada

Côté-Sergent, Aurélie; Échevin, Damien; Michaud, Pierre‐Carl

doi:10.1111/j.1475-5890.2016.12125

Cited by 7 publications

(1 citation statement)

References 22 publications

(14 reference statements)

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“…This is comparable to the age differences found in a Dutch study [8]. A decreasing age curve in very high age observed for HC cost is also found in several other studies [7,8,13,14], but not all [15,16]. We can only speculate on why there are differning age-patterns for the oldest.…”

Section: Age Profiles Of Hc and Ltc Per Capita Costsupporting

confidence: 90%

Health and care service utilisation and cost over the life-span: a descriptive analysis of population data

Kalseth

Halvorsen

2020

BMC Health Serv Res

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Background Current demographic changes affect both the level and composition of health and care needs in the population. The aim of this study was to estimate utilisation and cost for a comprehensive range of health and care services by age and gender to provide an in-depth picture of the life-span pattern of service needs and related costs. Methods Data on service use in 2010 for the entire population in Norway were collected from four high-quality national registers. Cost for different services were calculated combining data on service utilisation from the registries and estimates of unit cost. Data on cost and users were aggregated within four healthcare services and seven long-term care services subtypes. Per capita cost by age and gender was decomposed into user rates and cost per user for each of the eleven services. Results Half of the population is under 40 years of age, but only a quarter of the health and care cost is used on this age group. The age-group of 65 or older, on the other hand, represent only 15% of the population, but is responsible for almost half of the total cost. Healthcare cost dominates in ages under 80 and mental health services dominates in adolescents and young adults. Use of other healthcare services are high in middle aged and elderly but decreases for the oldest old. Use of care services and in particular institutional care increases in old age. Healthcare cost per user follows roughly the same age pattern as user rates, whereas user cost for care services typically are either relatively stable or decrease with age among adults. Gender differences in the age pattern of health and care costs are also revealed and discussed. Conclusion The type of services used, and the related cost, show a clear life-span as well as gender pattern. Hence, population aging and narrowing gender-gap in longivety calls for high policy awarness on changing health and care needs. Our study also underscores the need for an attentive and pro-active stance towards the high service prevalence and high cost of mental health care in our upcoming generations.

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Section: Age Profiles Of Hc and Ltc Per Capita Costsupporting

confidence: 90%

Health and care service utilisation and cost over the life-span: a descriptive analysis of population data

Kalseth

Halvorsen

2020

BMC Health Serv Res

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The economic burden of burned patients for hospitalization in Canada

Chouinard,

Beaudoin Cloutier,

Chang

et al. 2024

Burns

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Medical Spending of the US Elderly

et al. 2016

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We use data from the Medicare Current Beneficiary Survey (MCBS) to document the medical spending of Americans aged 65 and older. We find that medical expenses more than double between ages 70 and 90 and that they are very concentrated: the top 10 per cent of all spenders are responsible for 52 per cent of medical spending in a given year. In addition, those currently * Submitted June 2015. 718Fiscal Studies experiencing either very low or very high medical expenses are likely to find themselves in the same position in the future. We also find that the poor consume more medical goods and services than the rich and have a much larger share of their expenses covered by the government. Overall, the government pays for over 65 per cent of the elderly's medical expenses. Despite this, the expenses that remain after government transfers are even more concentrated among a small group of people. Thus, government health insurance, while potentially very valuable, is far from complete. Finally, while medical expenses before death can be large, on average they constitute only a small fraction of total spending, both in the aggregate and over the life cycle. Hence, medical expenses before death do not appear to be an important driver of the high and increasing medical spending found in the US. Policy pointsr Those at the top of the income distribution in the US consume 71 per cent as much health care resources as those at the bottom of the distribution per year.r Those in the last calendar year of life are responsible for 4.9 per cent of total spending. In the last 12 months of life, average medical spending is $59,000, accounting for 16.8 per cent of spending at ages 65 and over and for 6.7 per cent of spending at all ages. Medical spending in the three years before death accounts for 13.4 per cent of aggregate medical spending. r Total spending is on average about $1,100 per year more for women than for men, due to higher expenditures on nursing homes for women.r The financing of health care varies dramatically by income. In the bottom income quintile, Medicare pays $9,500 a year and Medicaid $3,900, while private insurance covers just $900 and out-of-pocket spending is $2,500. In the top income quintile, Medicare pays $6,300 and Medicaid only $300, while private insurance pays $2,400 and out-of-pocket spending is $3,000.r Medical spending is very persistent over time, with those in the top quintile of spending in one year having a 54 per cent chance of being in the top quintile in the next year and a 48 per cent chance of being in the top quintile in two years' time.

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The Concentration of Hospital‐Based Medical Spending: Evidence from Canada

Cited by 7 publications

References 22 publications

Health and care service utilisation and cost over the life-span: a descriptive analysis of population data

Health and care service utilisation and cost over the life-span: a descriptive analysis of population data

The economic burden of burned patients for hospitalization in Canada

Medical Spending of the US Elderly

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