Determinants of long-term care spending: Age, time to death or disability?

Claudine de Meijer, Marc Koopmanschap, Teresa Bago d' Uva and Eddy Van Doorslaer

Journal of Health Economics, 2011, vol. 30, issue 2, 425-438

Abstract: In view of population aging, better understanding of what drives long-term care expenditure (LTCE) is warranted. Time-to-death (TTD) has commonly been used to project LTCE because it was a better predictor than age. We reconsider the roles of age and TTD by controlling for disability and co-residence and illustrate their relevance for projecting LTCE. We analyze spending on institutional and homecare for the entire Dutch 55+ population, conditioning on age, sex, TTD, cause-of-death and co-residence. We further examined homecare expenditures for a sample of non-institutionalized conditioning additionally on disability. Those living alone or deceased from diabetes, mental illness, stroke, respiratory or digestive disease have higher LTCE, while a cancer death is associated with lower expenditures. TTD no longer determines homecare expenditures when disability is controlled for. This suggests that TTD largely approximates disability. Nonetheless, further standardization of disability measurement is required before disability could replace TTD in LTCE projections models.

Keywords: Aging; Long-term; care; Expenditures; Time-to-death; Homecare; Institutional; care (search for similar items in EconPapers)
Date: 2011
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Citations: View citations in EconPapers (72)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:30:y:2011:i:2:p:425-438

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