Healthcare Costs and Health Status: Insights from the SHARE Survey

Małgorzata Cygańska (), Magdalena Kludacz-Alessandri and Chris Pyke
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Małgorzata Cygańska: Department of Finance, Economics and Finance Institute, The Faculty of Economics University o Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
Magdalena Kludacz-Alessandri: The College of Economics and Social Sciences, Warsaw University of Technology, 09-400 Plock, Poland
Chris Pyke: Lancashire School of Business and Enterprise, University of Central Lancashire, Preston PR1 2HE, UK

IJERPH, 2023, vol. 20, issue 2, 1-14

Abstract: The substantial rise in hospital costs over recent years is associated with the rapid increase in the older age population. This study addresses an empirical gap in the literature concerning the determinants of high hospital costs in a group of older patients in Europe. The objective of the study is to examine the association of patient health status with in-hospital costs among older people across European countries. We used the data from the Survey of Health, Ageing and Retirement in Europe (SHARE) database. The analysis included 9671 patients from 18 European countries. We considered socio-demographic, lifestyle and clinical variables as possible factors influencing in-hospital costs. Univariate and multivariable logistic regression analyses were used to determine the determinants of in-hospital costs. To benchmark the hospital costs across European countries, we used the cost-outlier methodology. Rates of hospital cost outliers among older people varies from 5.80 to 12.65% across Europe. Factors associated with extremely high in-patient costs differ among European countries. In most countries, they include the length of stay in the hospital, comorbidities, functional mobility and physical activity. The treatment of older people reporting heart attack, diabetes, chronic lung disease and cancer are more often connected with cost outliers. The risk of being a cost outlier increased by 20% with each day spent in the hospital. We advocate that including patient characteristics in the reimbursement system could provide a relatively simple strategy for reducing hospitals’ financial risk connected with exceptionally costly cases.

Keywords: health status; cost outliers; older people; inpatient costs (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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