Estimating Lifetime Costs of Social Care: A Bayesian Approach Using Linked Administrative Datasets from Three Geographical Areas.

Abstract:

:We estimated lifetime costs of publicly funded social care, covering services such as residential and nursing care homes, domiciliary care and meals. Like previous studies, we constructed microsimulation models. However, our transition probabilities were estimated from longitudinal, linked administrative health and social care datasets, rather than from survey data. Administrative data were obtained from three geographical areas of England, and we estimated transition probabilities in each of these sites flexibly using Bayesian methods. This allowed us to quantify regional variation as well as the impact of structural and parameter uncertainty regarding the transition probabilities. Expected lifetime costs at age 65 were £20,200-27,000 for men and £38,700-49,000 for women, depending on which of the three areas was used to calibrate the model. Thus, patterns of social care spending differed markedly between areas, with mean costs varying by almost £10,000 (25%) across the lifetime for people of the same age and gender. Allowing for structural and parameter uncertainty had little impact on expected lifetime costs, but slightly increased the risk of very high costs, which will have implications for insurance products for social care through increasing requirements for capital reserves.

journal_name

Health Econ

journal_title

Health economics

authors

Steventon A,Roberts A

doi

10.1002/hec.3110

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

1573-87

issue

12

eissn

1057-9230

issn

1099-1050

journal_volume

24

pub_type

杂志文章
  • Household characteristics affecting where mothers deliver in rural Kenya.

    abstract::Data from a household survey were used to analyse the distribution of newborn deliveries in a rural area of Kenya. It was found that 52% of deliveries occurred at home or with traditional birth attendants. Using regression techniques, the most significant predictors of choosing an informal delivery setting are the hou...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/(SICI)1099-1050(199607)5:4<333::AID-HEC202

    authors: Hodgkin D

    更新日期:1996-07-01 00:00:00

  • Heterogeneous Effects of a Nonlinear Price Schedule for Outpatient Care.

    abstract::Nonlinear price schedules generally have heterogeneous effects on health-care demand. We develop and apply a finite mixture bivariate probit model to analyze whether there are heterogeneous reactions to the introduction of a nonlinear price schedule in the German statutory health insurance system. In administrative in...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3395

    authors: Farbmacher H,Ihle P,Schubert I,Winter J,Wuppermann A

    更新日期:2017-10-01 00:00:00

  • Tobacco initiation, cessation, and change: evidence from Vietnam.

    abstract::Studies of the impact of tobacco prices on decisions to initiate and quit smoking have, to date, largely been restricted to developed countries. Such analyses, when set in developing countries, are complicated by the availability of a wide range of tobacco products that are nicotine substitutes for cigarettes. This st...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.932

    authors: Laxminarayan R,Deolalikar A

    更新日期:2004-12-01 00:00:00

  • Global budgets and excess demand for hospital care.

    abstract::Excess demand is a pervasive feature of health care systems that use global budgets to pay for hospital care, regardless of the amount of money spent by those systems. This paper presents a theory that explains this feature of global budgets. The theory emphasizes that hospital administrators control the allocation of...

    journal_title:Health economics

    pub_type: 杂志文章,评审

    doi:10.1002/(sici)1099-1050(199703)6:2<187::aid-hec259

    authors: Feldman R,Lobo F

    更新日期:1997-03-01 00:00:00

  • Cyclical absenteeism among private sector, public sector and self-employed workers.

    abstract::This research note analyzes differences in the number of absent working days and doctor visits and in their cyclicality between private sector, public sector and self-employed workers. For this purpose, I used large-scale German survey data for the years 1995 to 2007 to estimate random effects negative binomial (count...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.2808

    authors: Pfeifer C

    更新日期:2013-03-01 00:00:00

  • Socioeconomic status and health outcomes in a developing country.

    abstract::Although the relationship between socioeconomic status (SES) and health is well documented for developed countries, less evidence has been presented for developing countries. The aim of this paper is to analyse this relationship at the household level for Fiji, a developing country in the South Pacific, using original...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.1703

    authors: Lordan G,Soto EJ,Brown RP,Correa-Valez I

    更新日期:2012-02-01 00:00:00

  • The impact of including future medical care costs when estimating the costs attributable to a disease: a colorectal cancer case study.

    abstract::A source of controversy in the economic literature concerns whether to include or exclude future medical care costs when computing attributable costs for lifesaving interventions. Although it is hypothesized that including future medical care costs will offset the cost savings achieved through prevention, the magnitud...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.580

    authors: Etzioni R,Ramsey SD,Berry K,Brown M

    更新日期:2001-04-01 00:00:00

  • An econometric study of costs of teaching and research in Finnish hospitals.

    abstract::In this study we used stochastic frontier cost functions to estimate the teaching and research costs of Finnish hospitals. Average and marginal cost estimates were used to evaluate the current reimbursement system as well as to calculate the total expenditure on teaching and research in hospitals. The efficiency adjus...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/(sici)1099-1050(199806)7:4<291::aid-hec343

    authors: Linna M,Häkkinen U,Linnakko E

    更新日期:1998-06-01 00:00:00

  • Effects of drought on infant mortality in China.

    abstract::This study focuses on Guizhou Province, a region with difficult geographical conditions and poor economic development, to examine the effect of rainfall shocks on contemporaneous infant health and long-run socioeconomic outcomes in China. The study results indicate that negative rainfall shocks are robustly correlated...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.4191

    authors: Lin Y,Liu F,Xu P

    更新日期:2021-02-01 00:00:00

  • Has the Swap Influenced Aid Flows in the Health Sector?

    abstract::The sector wide approach (SWAp) emerged during the 1990s as a mechanism for managing aid from the multiplicity of development partners that operate in the recipient country's health, education or agricultural sectors. Health SWAps aim to give increased control to recipient governments, allowing greater domestic influe...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3170

    authors: Sweeney R,Mortimer D

    更新日期:2016-05-01 00:00:00

  • Can cost shifting continue in a price competitive environment?

    abstract::Both Medicare and Medicaid are reducing payments to hospitals, and there is widespread concern that hospitals may respond by increasing prices to privately insured patients. Theoretical models of hospital behaviour have ambiguous predictions as to whether, and under what circumstances, hospitals will shift costs to pr...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/(sici)1099-1050(200004)9:3<211::aid-hec508

    authors: Zwanziger J,Melnick GA,Bamezai A

    更新日期:2000-04-01 00:00:00

  • Infant mortality and child nutrition in Bangladesh.

    abstract::The excess female infant mortality observed in South Asia has typically been attributed to gender discrimination in the intra-household allocation of food and medical care. However, studies on child nutrition find no evidence of gender differences. A natural explanation could be that in environments of high infant mor...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.1379

    authors: Dancer D,Rammohan A,Smith MD

    更新日期:2008-09-01 00:00:00

  • Childhood Obesity and Cognitive Achievement.

    abstract::Obese children tend to perform worse academically than normal-weight children. If poor cognitive achievement is truly a consequence of childhood obesity, this relationship has significant policy implications. Therefore, an important question is to what extent can this correlation be explained by other factors that joi...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3211

    authors: Black N,Johnston DW,Peeters A

    更新日期:2015-09-01 00:00:00

  • Estimation of the transition matrix of a discrete-time Markov chain.

    abstract::Discrete-time Markov chains have been successfully used to investigate treatment programs and health care protocols for chronic diseases. In these situations, the transition matrix, which describes the natural progression of the disease, is often estimated from a cohort observed at common intervals. Estimation of the ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.654

    authors: Craig BA,Sendi PP

    更新日期:2002-01-01 00:00:00

  • What is driving the black-white difference in low birthweight in the US?

    abstract::This is a first effort to quantify the contribution of different factors in explaining racial difference in low birthweight rate (LBW). Mother's health, child characteristics, prenatal care, socioeconomic status (SES), and the socioeconomic and healthcare environment of mother's community are important inputs into the...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.1715

    authors: Lhila A,Long S

    更新日期:2012-03-01 00:00:00

  • Physical activity and health outcomes: evidence from Canada.

    abstract::Health production models include participation in physical activity as an input. We investigate the relationship between participation in physical activity and health using a bivariate probit model. Participation is identified with an exclusion restriction on a variable reflecting sense of belonging to the community. ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.2900

    authors: Humphreys BR,McLeod L,Ruseski JE

    更新日期:2014-01-01 00:00:00

  • Winning big but feeling no better? The effect of lottery prizes on physical and mental health.

    abstract::We use British panel data to determine the exogenous impact of income on a number of individual health outcomes: general health status, mental health, physical health problems, and health behaviours (drinking and smoking). Lottery winnings allow us to make causal statements regarding the effect of income on health, as...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3035

    authors: Apouey B,Clark AE

    更新日期:2015-05-01 00:00:00

  • The Welfare Cost of Homicides in Brazil: Accounting for Heterogeneity in the Willingness to Pay for Mortality Reductions.

    abstract::This paper estimates the health dimension of the welfare cost of homicides in Brazil incorporating age, gender, educational, and regional heterogeneities. We use a marginal willingness to pay approach to assign monetary values to the welfare cost of increased mortality due to violence. Results indicate that the presen...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3137

    authors: Cerqueira D,Soares RR

    更新日期:2016-03-01 00:00:00

  • Empirical Testing of the External Validity of a Discrete Choice Experiment to Determine Preferred Treatment Option: The Case of Sleep Apnea.

    abstract::There is an increasing use of the discrete choice experiment (DCE) method in health care to estimate preferences of individuals and the public for different services. Despite this increasing use, there are few studies that investigate the validity of the DCE in health. This study investigates the external validity of ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3076

    authors: Krucien N,Gafni A,Pelletier-Fleury N

    更新日期:2015-08-01 00:00:00

  • The effects of HIV medications on the quality of life of older adults in New York City.

    abstract::A three-equation model is used to estimate the multiple effects of antiretroviral medications (ARVs) on the quality of life (QoL) of the elderly with HIV in New York City. The transmission mechanism involves the ARVs having a direct effect on QoL via the side effects of the medications and two other effects (one indir...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.1774

    authors: Brent RJ

    更新日期:2012-08-01 00:00:00

  • Constraints on Formulary Design Under the Affordable Care Act.

    abstract::I study the effect of prescription drug essential health benefits (EHB) requirements from the Affordable Care Act on prescription drug formularies of health insurance marketplace plans. The EHB regulates the number of drugs covered but leaves other dimensions (cost sharing and utilization management) of the formulary ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3491

    authors: Andersen M

    更新日期:2017-12-01 00:00:00

  • Population Aging and Healthcare Expenditure in Korea.

    abstract::Korea's rapid population aging has been considered as a major factor in increase of healthcare expenditure (HCE). However, there were no clear empirical evidences in Korea that show if population aging has a significant impact on HCE. To examine the 'red herring' argument, this study used Heckman, two-part, and augmen...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3209

    authors: Hyun KR,Kang S,Lee S

    更新日期:2016-10-01 00:00:00

  • Teacher training and HIV/AIDS prevention in West Africa: regression discontinuity design evidence from the Cameroon.

    abstract::We assess the impact on teenage childbearing as well as student knowledge, attitudes, and behavior of a typical HIV/AIDS teacher training program in the Cameroon. Applying a regression discontinuity design identification strategy based on the key administrative criterion that determined program deployment, we find tha...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.1643

    authors: Arcand JL,Wouabe ED

    更新日期:2010-09-01 00:00:00

  • The effect of prenatal care on birthweight: a full-information maximum likelihood approach.

    abstract::This paper uses a full-information maximum likelihood estimation procedure, the Discrete Factor Method, to estimate the relationship between birthweight and prenatal care. This technique controls for the potential biases surrounding both the sample selection of the pregnancy-resolution decision and the endogeneity of ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.801

    authors: Rous JJ,Jewell RT,Brown RW

    更新日期:2004-03-01 00:00:00

  • Do competition and managed care improve quality?

    abstract::In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.726

    authors: Sari N

    更新日期:2002-10-01 00:00:00

  • The wear and tear on health: What is the role of occupation?

    abstract::Health is well known to show a clear gradient by occupation. Although it may appear evident that occupation can affect health, there are multiple possible sources of selection that can generate a strong association, other than simply a causal effect of occupation on health. We link job characteristics to German panel ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3563

    authors: Ravesteijn B,Kippersluis HV,Doorslaer EV

    更新日期:2018-02-01 00:00:00

  • Estimating survival gain for economic evaluations with survival time as principal endpoint: a cost-effectiveness analysis of adding early hormonal therapy to radiotherapy in patients with locally advanced prostate cancer.

    abstract::The problem of estimating expected outcomes for the economic evaluation of treatments for which the outcome of principal interest is (quality adjusted) survival time has so far not received sufficient attention in the literature. The best estimate of expected survival is mean survival time, but with censored survival ...

    journal_title:Health economics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/hec.662

    authors: Neymark N,Adriaenssen I,Gorlia T,Caleo S,Bolla M

    更新日期:2002-04-01 00:00:00

  • Optimal cost reimbursement of health insurers to reduce risk selection.

    abstract::In the absence of a perfect risk adjustment scheme, reimbursing health insurers' costs can reduce risk selection in community-rated health insurance markets. In this paper, we develop a model in which insurers determine the cost efficiency of health care and have incentives for risk selection. We derive the optimal co...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.1614

    authors: Kifmann M,Lorenz N

    更新日期:2011-05-01 00:00:00

  • High School Physical Education Requirements and Youth Body Weight: New Evidence from the YRBS.

    abstract::Previous research has found that high school physical education (PE) requirements are largely ineffective at reducing youth body weight. However, these studies were forced to rely on cross-state variation in PE requirements to identify their impacts, raising concerns that estimated policy effects may be confounded by ...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3399

    authors: Sabia JJ,Nguyen TT,Rosenberg O

    更新日期:2017-10-01 00:00:00

  • The impact of the Affordable Care Act on self-employment.

    abstract::This paper estimates the impact of the implementation of the Affordable Care Act (ACA) in 2014 on the decision to be self-employed. Using data from the Current Population Survey, we employ two identification strategies. Utilizing prereform variation in state nongroup health insurance market regulations, we find that t...

    journal_title:Health economics

    pub_type: 杂志文章

    doi:10.1002/hec.3500

    authors: Heim BT,Yang LK

    更新日期:2017-12-01 00:00:00