Time to death and health expenditure: an improved model for the impact of demographic change on health care costs.

Abstract:

BACKGROUND:Obtaining well-founded estimates of the effect of demographic change on future health expenditures is a pressing issue in all developed countries. Thus far, expenditure projections have examined the effect of age on health care costs, but fail to account for the influence of remaining life expectancy on costs. OBJECTIVE:This paper seeks to create a more accurate projection model that considers the concentration of costs towards the end of life, and to compare this model with the more traditional approach that holds age- and sex-specific per capita expenditures constant. METHODS:We used a longitudinal hospital dataset which followed 90 929 patients aged 65 and older from 1970 to death, to create an economic model of hospital costs based on patient age and time remaining to death. We then applied the model to England population projections to predict the effect of demographic changes on hospital expenditures from 2002 to 2026. RESULTS:The decline in age-specific mortality rates over time postpones death to later ages, pushing back death-related costs. Accounting for this in expenditure projections gave a predicted annual growth rate of 0.40%-half of the rate predicted with a traditional method. CONCLUSIONS:Using richer data and more refined methods than have hitherto been employed, this study strongly confirms that the pressure of population increases and ageing demographic structure on hospital expenditures will be partially countered by the postponement of death-related hospital costs to later in life-a finding consistent with emerging epidemiological evidence, and heartening for policy makers and physicians alike.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Seshamani M,Gray A

doi

10.1093/ageing/afh187

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

556-61

issue

6

eissn

0002-0729

issn

1468-2834

pii

afh187

journal_volume

33

pub_type

杂志文章
  • Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes.

    abstract:INTRODUCTION:care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. METHODS:a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies select...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afx195

    authors: Gordon AL,Goodman C,Davies SL,Dening T,Gage H,Meyer J,Schneider J,Bell B,Jordan J,Martin FC,Iliffe S,Bowman C,Gladman JRF,Victor C,Mayrhofer A,Handley M,Zubair M

    更新日期:2018-07-01 00:00:00

  • A study of religious attitudes of the elderly.

    abstract::A study is reported of the religious beliefs, attitudes, and practice of old people in the West of Scotland, based on a questionnaire given to 501 people aged 65 years and over randomly selected from those living at home. Almost all had had a full range of religious instruction, and regarded their parents as religious...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/7.1.40

    authors: Reid WS,Gilmore AJ,Andrews GR,Caird FI

    更新日期:1978-02-01 00:00:00

  • Predictors of depressive symptoms in older people--a survey of two general practice populations.

    abstract:BACKGROUND:Studies have shown strong associations between disability, social support and depressive symptoms in older people; but socio-economic effects are less clear and little is known about the role of health locus of control. OBJECTIVE:To examine the roles of physical health, disability, social support, socio-eco...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afg087

    authors: Harris T,Cook DG,Victor C,Rink E,Mann AH,Shah S,DeWilde S,Beighton C

    更新日期:2003-09-01 00:00:00

  • Electrocardiographic abnormalities in the sick elderly.

    abstract::From a study of routine electrocardiography on 300 ill elderly patients in an acute geriatric unit, it is evident that the incidence of atrial fibrillation, ventricular extrasystoles, myocardial ischaemia and myocardial infarction is much higher than in the general population of similar age group. In females, the inci...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/6.3.163

    authors: Patel KP

    更新日期:1977-08-01 00:00:00

  • Missed diagnosis of pulmonary embolism with age-adjusted d-dimer cut-off value.

    abstract::Pulmonary embolism (PE) is a potentially severe diagnosis with high short-term mortality. Recently, age-adjusted cut-off values (age × 10 μg/l) of D-dimer were introduced to improve the diagnostic workup in older patients. In clinical practice, PE is considered 'ruled out' in patients with a non-high clinical probabil...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afw132

    authors: Stein CE,Keijsers CJ,Bootsma JE,Schouten HJ

    更新日期:2016-11-01 00:00:00

  • Management of spasticity revisited.

    abstract::Spasticity is common after stroke and other neurological conditions and causes considerable limitations of movement, activities of daily living and participation. Interaction with other components of the upper motor neurone syndrome (UMNS) and the heterogeneity of patients' presentations together with limited tools fo...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/aft064

    authors: Graham LA

    更新日期:2013-07-01 00:00:00

  • Myocardial contractility in aged rats.

    abstract::The elastic and mechanical behaviour of isolated papillar muscle was studied in aged and in young rats. The spontaneous fall in tension (stress relaxation phenomenon) and the duration of the active state of the contractile element during the isometric and isotonic contraction were greater in aged than in young rats. T...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/5.2.71

    authors: Minelli R,Reggiani C,De Nicola P

    更新日期:1976-05-01 00:00:00

  • The factors associated with self-reported physical activity in older adults living in the community.

    abstract:BACKGROUND:despite the vast literature in the area, few studies examined the large range of factors associated with physical activity (PA) in the older adult collectively, information that could help develop a supportive culture for healthy ageing. OBJECTIVE:to identify the socio-demographic, social connectedness, phy...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afv042

    authors: McKee G,Kearney PM,Kenny RA

    更新日期:2015-07-01 00:00:00

  • Inappropriate prescribing in the older population: need for new criteria.

    abstract::Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been de...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/afm189

    authors: O'Mahony D,Gallagher PF

    更新日期:2008-03-01 00:00:00

  • Circulating oxidised LDL lipids, when proportioned to HDL-c, emerged as a risk factor of all-cause mortality in a population-based survival study.

    abstract:BACKGROUND AND OBJECTIVE:the data concerning the predictive role of oxidised LDL (ox-LDL) in all-cause mortality are scarce. We investigated whether circulating ox-LDL would stand out as a risk factor of total mortality in the elderly. Study subjects, design and methods: a total of 1,260 elderly inhabitants (533 men, 7...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afs074

    authors: Linna M,Ahotupa M,Löppönen MK,Irjala K,Vasankari T

    更新日期:2013-01-01 00:00:00

  • Impact of endovascular reperfusion therapy in nonagenarians with anterior circulation large-vessel ischaemic stroke.

    abstract:BACKGROUND AND PURPOSE:The benefit of endovascular thrombectomy (EVT) among nonagenarians (90 years or older) is poorly documented. We aimed to investigate the clinical and imaging factors associated with good outcomes and mortality at 90 days in nonagenarians undergoing EVT for acute ischemic stroke (AIS). METHODS:Da...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa243

    authors: Derraz I,Benali A,Ahmed R,Cagnazzo F,Dargazanli C,Gascou G,Riquelme C,Corti L,Lefevre PH,Bonafe A,Arquizan C,Costalat V

    更新日期:2020-11-17 00:00:00

  • Changes in physical and mental health are associated with cardiovascular disease incidence in postmenopausal women.

    abstract:BACKGROUND:physical and mental health are important risk factors for cardiovascular disease (CVD) incidence and death among postmenopausal women. The objective of this study was to assess whether changes in physical and mental health were associated with CVD incidence and death. METHODS:in the Women's Health Initiativ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afy213

    authors: Saquib N,Brunner R,Desai M,Kroenke C,Martin LW,Daviglus M,Allen NB,Robinson J,Tindle H,Stefanick ML

    更新日期:2019-05-01 00:00:00

  • Are older patients with diabetes still being overtreated in French long-term care homes?

    abstract:BACKGROUND:Diabetes management has not been evaluated in French nursing homes (NHs) for 10 years. OBJECTIVES:The present study aimed to compare the management of diabetes with guidelines in older patients living in NHs. DESIGN:Observational, retrospective and multicentre study carried out in 13 NH in the Cote d'Or re...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa051

    authors: Quilot E,Petit JM,Vergès B,Bouillet B

    更新日期:2020-08-24 00:00:00

  • Comparative effectiveness of sitagliptin vs sulphonylureas in older people.

    abstract:BACKGROUND:two common anti-diabetic treatments used are sitagliptin and sulphonylureas however evidence examining their comparative effectiveness in older people is limited. OBJECTIVE:to evaluate effectiveness of sitagliptin vs sulphonylureas when added to metformin in older (aged ≥75) vs younger people (18-75). DESI...

    journal_title:Age and ageing

    pub_type: 杂志文章,多中心研究

    doi:10.1093/ageing/afz078

    authors: Sharma M,Nazareth I,Petersen I

    更新日期:2019-09-01 00:00:00

  • The impact of first- and second-eye cataract surgery on injurious falls that require hospitalisation: a whole-population study.

    abstract:BACKGROUND:cataract is a leading cause of reversible vision impairment and may increase falls in older adults. OBJECTIVE:to assess the risk of an injury due to a fall among adults aged 60+, 2 years before first-eye cataract surgery, between first-eye surgery and second-eye surgery and 2 years after second-eye surgery....

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft177

    authors: Meuleners LB,Fraser ML,Ng J,Morlet N

    更新日期:2014-05-01 00:00:00

  • Teaching geriatric medicine to medical students--a summary.

    abstract::Within the wide range of topics embraced in the subject of geriatric medicine, a division may be made as far as teaching is concerned into: 1. those that could be taught by other people; 2. those that should be taught by other people; 3. those that cannot be taught by other people. If attitudes throughout the medical ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:

    authors: Millard PH

    更新日期:1983-01-01 00:00:00

  • Confirming long-stay status.

    abstract::This paper discusses an assessment procedure for the formal identification of patients requiring long-stay geriatric care. It was introduced immediately prior to the reorganization of geriatric in-patient care at St Pancras Hospital which saw the abolition of mixed wards of acute, rehabilitation, and long-stay patient...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/16.1.13

    authors: Golding R,Lugon M,Hodkinson HM

    更新日期:1987-01-01 00:00:00

  • A longitudinal study of knee pain in older men: Concord Health and Ageing in Men Project.

    abstract:BACKGROUND:chronic knee pain is still considered a fairly benign disease by many, an 'unavoidable' consequence of ageing. This passive acceptance may be unnecessarily exposing older people to disability and serious co-morbidity. The aim of this study was to determine the disease burden associated with chronic knee pain...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft188

    authors: Fransen M,Su S,Harmer A,Blyth FM,Naganathan V,Sambrook P,Le Couteur D,Cumming RG

    更新日期:2014-03-01 00:00:00

  • Snoring and dementia.

    abstract::The frequency of snoring was studied in 46 patients with Alzheimer's disease (AD), 37 with multiinfarct dementia (MID), and in a random sample of 124 elderly community residents without known diseases affecting higher cortical functions. The demented patients were reported to snore twice as frequently as the control s...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/16.5.305

    authors: Erkinjuntti T,Partinen M,Sulkava R,Palomaki H,Tilvis R

    更新日期:1987-09-01 00:00:00

  • Glaucoma therapy may take your breath away.

    abstract::Chronic simple glaucoma is a common disease in old age and lowering intraocular pressure is the treatment strategy. Although this can be achieved surgically, medical treatment with eye drops is more often prescribed. Beta-antagonists are the class of drug most often chosen, although other medical therapies are availab...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/26.2.63

    authors: Diggory P,Franks WA

    更新日期:1997-03-01 00:00:00

  • Gender and longitudinal changes in physical activities in later life.

    abstract:OBJECTIVES:to describe gender differences in levels of, and longitudinal changes in, habitual physical activity among older people. DESIGN:longitudinal study. PARTICIPANTS:sub-groups of survivors (with sample sizes dependent on the availability of complete datasets, ranging from 303-344) assessed on three occasions: ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/27.suppl_3.24

    authors: Bennett KM

    更新日期:1998-12-01 00:00:00

  • Does admission to hospital improve the outcome for stroke patients?

    abstract:OBJECTIVES:to identify the factors associated with hospital admission and the differences in management and outcome of stroke patients between hospital and home. DESIGN:a prospective community stroke register (1995-8) with multiple notification sources. SETTING:an inner city multi-ethnic population of 234 533 in Sout...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/30.3.197

    authors: Bhalla A,Dundas R,Rudd AG,Wolfe CD

    更新日期:2001-05-01 00:00:00

  • Frailty state utility and minimally important difference: findings from the North West Adelaide Health Study.

    abstract:BACKGROUND:frailty is a dynamic condition for which a range of interventions are available. Health state utilities are values that represent the strength of an individual's preference for specific health states, and are used in economic evaluation. This is a topic yet to be examined in detail for frailty. Likewise, lit...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa166

    authors: Thompson MQ,Theou O,Ratcliffe J,Tucker GR,Adams RJ,Walters SJ,Visvanathan R

    更新日期:2020-09-16 00:00:00

  • Senile parkinsonism, a study of current treatment.

    abstract::In a survey of all 2069 in-patients at 14 geriatric centres, 249 patients were found to have received drugs for the treatment of parkinsonism. There was a wide variation in point prevalence which varied from 4.6% to 22.6% between centres. Levodopa, usually in combination with a decarboxylase inhibitor, was the most fr...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/10.2.81

    authors: White NJ,Barnes TR

    更新日期:1981-05-01 00:00:00

  • Education associated with a delayed onset of terminal decline.

    abstract:BACKGROUND:the terminal decline hypothesis suggests an acceleration in the rate of loss of cognitive function before death. Evidence about the association of educational attainment and the onset of terminal decline is scarce. OBJECTIVE:to investigate the association of education with the onset of terminal decline in g...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft150

    authors: Terrera GM,Minett T,Brayne C,Matthews FE

    更新日期:2014-01-01 00:00:00

  • The usefulness of carotid sinus massage in different patient groups.

    abstract:AIM:to determine the positive yield of carotid sinus massage in different patient groups: unexplained syncope, falls, dizziness and controls. DESIGN:observational study. SETTING:teaching hospital. METHODS:we studied consecutive patients over the age of 60 years referred to the 'falls clinic' with a history of unexpl...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afg114

    authors: Kumar NP,Thomas A,Mudd P,Morris RO,Masud T

    更新日期:2003-11-01 00:00:00

  • Delay in diagnosis of colorectal cancer in elderly patients.

    abstract::The medical histories of 178 colorectal cancer patients were studied retrospectively from hospital records. The average age at the time of diagnosis was 71 years. Visible loss of blood or anaemia were the commonest features. The mean time from first symptom to first medical consultation was 82.8 days. Men under 65 yea...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/22.4.260

    authors: Kemppainen M,Räihä I,Rajala T,Sourander L

    更新日期:1993-07-01 00:00:00

  • An unusual presentation of sporadic Creutzfeldt-Jakob disease.

    abstract::Sporadic Creutzfeld-Jakob disease (CJD) is a rare neurodegenerative disorder. It is uniformly fatal. Clinical signs include myoclonus, visual disturbances, cerebellar ataxia, akinetic mutism and pyramidal/extrapyramidal signs in addition to a rapidly progressive dementia. Premortem diagnosis is challenging due to the ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa013

    authors: Podger H,Ipe A

    更新日期:2020-04-27 00:00:00

  • The association between Healthy Eating Index-2005 scores and disability among older Americans.

    abstract:BACKGROUND:several studies examining diet and functional status of individuals have focused on single nutrients or food groups. Studies examining the relationship between diet and health have increasingly witnessed a shift in focus from single nutrients to overall diet quality. The objective of this study was to examin...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afr158

    authors: Xu B,Houston D,Locher JL,Zizza C

    更新日期:2012-05-01 00:00:00

  • Cognitive decline with chronic meningitis secondary to a COX-2 inhibitor.

    abstract::Non-steroidal anti-inflammatory drugs are currently being investigated as agents to reduce the incidence and progression of Alzheimer's disease. Paradoxically they have also been reported to induce deleterious effects on the central nervous system, including aseptic meningitis and cognitive decline in the elderly. We ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afh112

    authors: Ashton D,Kim P,Griffiths N,Beran R

    更新日期:2004-07-01 00:00:00