Relatively little is known about the association between ageing and health care costs in middle- and low-income countries - whereas, in high income countries, available data does not yet point to a clear answer - with income elasticity and patient expectations, time to death, the type of service (inpatient or outpatient), and expensive technology, all possibly contributing more to increased spending than ageing populations.
See for example, Asia in the ageing century: Part III - Health care. www.cepar.edu.au/media/113850/asia_in_the_ageing_century_-_part_iii_-_healthcare.pdf
Any relevant and recent (last 5 years) analyses, published or in the grey literature, would be appreciated.
This chapter in the handbook of health economics could be a starting point.
http://www.sciencedirect.com/science/article/pii/S1574006400801602
I would consider the pathway of more chronic diseases affecting older people. In other words, irrespective of the wealth of the country, chronic diseases are affecting all countries. For the wealthier, non-communicable diseases (NCD) like diabetes, ischaemic heart disease, stroke etc living longer but afflicted with more chronic NCD. For the low-income and to some extent middle-income, as aresult of environmental factors related to poverty, NCD are alos on the increase.
A publication in the Lancet (below) may help:
Abegunde, D. O., Mathers, C. D., Adam, T., Ortegon, M., & Strong, K. (2007). The burden and costs of chronic diseases in low-income and middle-income countries. The Lancet, 370(9603), 1929-1938.
Abstract
"This paper estimates the disease burden and loss of economic output associated with chronic diseases—mainly cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes—in 23 selected countries which account for around 80% of the total burden of chronic disease mortality in developing countries. In these 23 selected low-income and middle-income countries, chronic diseases were responsible for 50% of the total disease burden in 2005. For 15 of the selected countries where death registration data are available, the estimated age-standardised death rates for chronic diseases in 2005 were 54% higher for men and 86% higher for women than those for men and women in high-income countries. If nothing is done to reduce the risk of chronic diseases, an estimated US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015. Achievement of a global goal for chronic disease prevention and control—an additional 2% yearly reduction in chronic disease death rates over the next 10 years—would avert 24 million deaths in these countries, and would save an estimated $8 billion, which is almost 10% of the projected loss in national income over the next 10 years."
Dear Jose-Ignacio and Sandra,
Do appreciate your responses. What I am looking for is recent published or unpublished literature/data on health systems responses to population ageing, the determinants and drivers in LMICs. The NCD burden will certainly be one component of health system expenditures unless we can change the trajectory of ageing at an earlier stage in life.
Sincerely, Paul
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