I would appreciate key reviews/summaries and published/unpublished manuscripts - looking at for example, ageing, expectations, population growth, time-to-death versus inappropriate use of expensive technology, health care practices, etc.
For example, see
Atella, et al. The effect of age and time to death on primary care costs: the Italian experience. Soc Sci Med. 2014;114:10-7.
Blakely et al. Health system costs by sex, age and proximity to death, and implications for estimation of future expenditure. NZ Med J. 2014;127(1393):12-25.
Great question !
As yet, I don't think we know the correlations or % contributions of demographics shifts and non demographic factors as they relate to health care spending. Both of these broad factors likely have correlation. However, the categories are likely not to be truly independent of one another and therefore how each component in each catergory influences the other may be important. In addition, the shifts in both demographic factors and non-demographic factors may ultimately lead to changes in health care spending that evolve in different directions (even opposite) depending upon the changes in culture and societal and ultimately individual expectations, beliefs and attitudes toward health care spending /utilization. The latter usually correlate positively, but policy may be likely important factors in ultimately determining changes in spending and/or utlization over time. Media and governmental roles also contribute and what may be measured a a change over time could be mistakenly attributed to both demographic and non-demographic changes.
Possibly the paper I wrote jointly with Cinzia Di Novi, (Is caring for older parents detrimental to women’s mental health? The role of the European North–South gradient, DOI 10.1007/s11150-015-9296-7) could be of interest. Although it does not address directly to health care costs, there are some interesting points on the different long term care systems across Europe, according to a North-South gradient. You may see that societal, religious, institutional factors representing the three European macro-areas (respectively Northern Central and Southern Europe) impact on the way the family take care of the elderly. And that the more each Country spends on LTC, the less the families are involved in assisting their older relatives. Hope you will find it interesting.
Hi Paul,
Like Alan, I think it's a monumental task to come up with a figure - even a range on the impact of demographic change on healthcare spending not least because of the comparability of data even as the OECD try to rectify this matter. There is even debate as to the direction of the impact. Consequently, such an endeavor would be courageous as it would be riveting.
That being said, two references that might be helpful are:
Payne G, Laporte A, Deber R, Coyte PC. 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. 2007 Jun;85(2):213-57.
Reinhardt UE.Does the aging of the population really drive the demand for health care? Health Aff (Millwood). 2003 Nov-Dec;22(6):27-39.
Cheers,
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