Health and care service utilisation and cost over the life-span: a descriptive analysis of population data.
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Health Care Costs
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Long-Term Care
/ economics
Male
Mental Health Services
/ economics
Middle Aged
Norway
Patient Acceptance of Health Care
/ statistics & numerical data
Registries
Sex Factors
Young Adult
Age pattern
Gender differences
Health care costs
Health services
Home care
Hospital
Long-term care
Nursing home
Utilisation
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
19 May 2020
19 May 2020
Historique:
received:
10
01
2020
accepted:
05
05
2020
entrez:
21
5
2020
pubmed:
21
5
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Current demographic changes affect both the level and composition of health and care needs in the population. The aim of this study was to estimate utilisation and cost for a comprehensive range of health and care services by age and gender to provide an in-depth picture of the life-span pattern of service needs and related costs. Data on service use in 2010 for the entire population in Norway were collected from four high-quality national registers. Cost for different services were calculated combining data on service utilisation from the registries and estimates of unit cost. Data on cost and users were aggregated within four healthcare services and seven long-term care services subtypes. Per capita cost by age and gender was decomposed into user rates and cost per user for each of the eleven services. Half of the population is under 40 years of age, but only a quarter of the health and care cost is used on this age group. The age-group of 65 or older, on the other hand, represent only 15% of the population, but is responsible for almost half of the total cost. Healthcare cost dominates in ages under 80 and mental health services dominates in adolescents and young adults. Use of other healthcare services are high in middle aged and elderly but decreases for the oldest old. Use of care services and in particular institutional care increases in old age. Healthcare cost per user follows roughly the same age pattern as user rates, whereas user cost for care services typically are either relatively stable or decrease with age among adults. Gender differences in the age pattern of health and care costs are also revealed and discussed. The type of services used, and the related cost, show a clear life-span as well as gender pattern. Hence, population aging and narrowing gender-gap in longivety calls for high policy awarness on changing health and care needs. Our study also underscores the need for an attentive and pro-active stance towards the high service prevalence and high cost of mental health care in our upcoming generations.
Sections du résumé
BACKGROUND
BACKGROUND
Current demographic changes affect both the level and composition of health and care needs in the population. The aim of this study was to estimate utilisation and cost for a comprehensive range of health and care services by age and gender to provide an in-depth picture of the life-span pattern of service needs and related costs.
METHODS
METHODS
Data on service use in 2010 for the entire population in Norway were collected from four high-quality national registers. Cost for different services were calculated combining data on service utilisation from the registries and estimates of unit cost. Data on cost and users were aggregated within four healthcare services and seven long-term care services subtypes. Per capita cost by age and gender was decomposed into user rates and cost per user for each of the eleven services.
RESULTS
RESULTS
Half of the population is under 40 years of age, but only a quarter of the health and care cost is used on this age group. The age-group of 65 or older, on the other hand, represent only 15% of the population, but is responsible for almost half of the total cost. Healthcare cost dominates in ages under 80 and mental health services dominates in adolescents and young adults. Use of other healthcare services are high in middle aged and elderly but decreases for the oldest old. Use of care services and in particular institutional care increases in old age. Healthcare cost per user follows roughly the same age pattern as user rates, whereas user cost for care services typically are either relatively stable or decrease with age among adults. Gender differences in the age pattern of health and care costs are also revealed and discussed.
CONCLUSION
CONCLUSIONS
The type of services used, and the related cost, show a clear life-span as well as gender pattern. Hence, population aging and narrowing gender-gap in longivety calls for high policy awarness on changing health and care needs. Our study also underscores the need for an attentive and pro-active stance towards the high service prevalence and high cost of mental health care in our upcoming generations.
Identifiants
pubmed: 32429985
doi: 10.1186/s12913-020-05295-2
pii: 10.1186/s12913-020-05295-2
pmc: PMC7236310
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
435Subventions
Organisme : Norges Forskningsråd
ID : 214298
Références
Int Psychogeriatr. 2009 Dec;21(6):1015-25
pubmed: 19589192
BMJ Open. 2018 Sep 8;8(9):e023113
pubmed: 30196269
Appl Health Econ Health Policy. 2018 Feb;16(1):15-29
pubmed: 28856585
Aging Clin Exp Res. 2008 Apr;20(2):91-102
pubmed: 18431075
Eur J Ageing. 2013;10(4):271-277
pubmed: 24319404
Int J Public Health. 2018 Jul;63(6):673-681
pubmed: 29654335
J Multidiscip Healthc. 2010 Mar 24;3:11-8
pubmed: 21197351
Acta Anaesthesiol Scand. 2014 Mar;58(3):329-36
pubmed: 24405518
Lancet. 2015 Feb 7;385(9967):549-62
pubmed: 25468153
Epidemiol Psychiatr Sci. 2019 Apr;28(2):210-223
pubmed: 28918762
Disabil Health J. 2015 Oct;8(4):535-46
pubmed: 26082321
J Geriatr Phys Ther. 2018 Jan/Mar;41(1):42-48
pubmed: 27341327
Lancet. 2015 Feb 7;385(9967):563-75
pubmed: 25468158
Med Care. 1987 Jan;25(1):1-8
pubmed: 3807446
Popul Health Manag. 2019 Apr;22(2):127-137
pubmed: 30096023
J Neurol Neurosurg Psychiatry. 2017 Aug;88(8):621-625
pubmed: 28365589
Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):250-6
pubmed: 20006391
Can J Nurs Res. 2005 Dec;37(4):138-54
pubmed: 16541823
JAMA Netw Open. 2019 Aug 2;2(8):e198398
pubmed: 31373653
PLoS One. 2015 Dec 14;10(12):e0144203
pubmed: 26658776
Lancet. 2015 Jul 11;386(9989):163-70
pubmed: 25935825
Lancet Neurol. 2016 Apr;15(5):451-2
pubmed: 26987699
J Epidemiol Community Health. 2014 Jul;68(7):649-56
pubmed: 24616352
BMC Public Health. 2015 Apr 23;15:415
pubmed: 25903064
Acta Anaesthesiol Scand. 2013 Jul;57(6):698-703
pubmed: 23373851
JAMA Psychiatry. 2014 May;71(5):573-81
pubmed: 24806211
Mech Ageing Dev. 2019 Apr;179:44-50
pubmed: 30825457
Arch Gerontol Geriatr. 2019 Sep - Oct;84:103898
pubmed: 31228673
J Appl Res Intellect Disabil. 2017 Jul;30(4):782-785
pubmed: 27364954
Eur J Ageing. 2013 May 15;10(4):353-361
pubmed: 28804308
BMC Med Inform Decis Mak. 2017 Apr 13;17(1):39
pubmed: 28407806
Health Psychol Rev. 2015;9(2):264-76
pubmed: 26209212
J Epidemiol Community Health. 2016 Jul;70(7):722-9
pubmed: 26933121
Open Med. 2014 Mar 04;8(1):e33-45
pubmed: 25009683
BMC Health Serv Res. 2017 Sep 18;17(1):667
pubmed: 28923106
Health Soc Care Community. 2016 May;24(3):297-308
pubmed: 25706800
Dement Geriatr Cogn Dis Extra. 2015 Sep 04;5(3):320-9
pubmed: 26483831
Acta Anaesthesiol Scand. 2012 Nov;56(10):1298-305
pubmed: 23016991
J Gerontol A Biol Sci Med Sci. 2019 Apr 23;74(5):659-666
pubmed: 29726918
Age Ageing. 2010 Jan;39(1):31-8
pubmed: 19934075
J Gerontol B Psychol Sci Soc Sci. 2010 May;65B(3):370-80
pubmed: 20371551
Arch Intern Med. 2006 Feb 27;166(4):418-23
pubmed: 16505261
Lancet. 2007 Apr 14;369(9569):1302-1313
pubmed: 17434406
Risk Manag Healthc Policy. 2019 Feb 14;12:23-30
pubmed: 30858741
BMC Health Serv Res. 2011 May 26;11:126
pubmed: 21615911
PLoS One. 2013;8(1):e55176
pubmed: 23372832
Maturitas. 2017 Aug;102:50-55
pubmed: 28610683
Clin Chem. 2019 Jan;65(1):135-145
pubmed: 30478135
PLoS One. 2019 Jun 11;14(6):e0217829
pubmed: 31185033
Proc Natl Acad Sci U S A. 2015 Jul 21;112(29):8993-8
pubmed: 26150507