More than one red herring'? Heterogeneous effects of ageing on health care utilisation

We study the effect of ageing, defined as an extra year of life, on health care utilisation. We disentangle the direct effect of ageing, from other alternative explanations such as the presence of comorbidities and endogenous time to death (TTD) that are argued to absorb the effect of ageing (so‐cal...

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Bibliographic Details
Published in:Health economics 2020-10, Vol.29 (S1), p.8-29
Main Authors: Costa‐Font, Joan, Vilaplana‐Prieto, Cristina
Format: Article
Language:English
Subjects:
ageing
Aging
comorbidities
End of life decisions
endogeneous time to death (TTD)
Endogenous
Health care
health care utilisation
Health economics
Health services utilization
home help use and comorbidity
hospital care
Hypotheses
Inpatient care
medicines use
Outpatient treatment
time to death
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Summary:We study the effect of ageing, defined as an extra year of life, on health care utilisation. We disentangle the direct effect of ageing, from other alternative explanations such as the presence of comorbidities and endogenous time to death (TTD) that are argued to absorb the effect of ageing (so‐called ‘red herring' hypothesis). We exploit individual level end of life data from several European countries that record the use of medicine, outpatient and inpatient care and long‐term care. Consistently with the ‘red herring hypothesis', we find that corrected TTD estimates are significantly different from uncorrected ones, and their effect size exceeds that of an extra year of life, which in turn is moderated by individual comorbidities. Corrected estimates suggest an overall attenuated effect of ageing, which does not influence outpatient care utilisation. These results suggest the presence of ‘more than one red herring' depending on the type of health care examined.
ISSN:1057-9230
1099-1050
DOI:10.1002/hec.4035