Scientific Center for Transformation in Care and Welfare (TRANZO), Tilburg University, Tilburg, The Netherlands.
Health Econ. 2011 Aug;20(8):985-1008. doi: 10.1002/hec.1664. Epub 2010 Oct 13.
In this paper, we investigate the relationship between baseline health and costs of hospital use over a period of eight years. We combine cross-sectional survey data with information from the Dutch national hospital register. Four different indicators of health (self-perceived health, long-term impairments, ADL limitations and comorbidity) are considered. We find that for ages 50 to 70, differences in hospital costs between good health and bad health are substantial and persist during the whole time period. However, for higher ages expected hospital costs for individuals in bad health decline rapidly and become lower than those for people in good health after about six to seven years. The higher mortality rate among people in bad health is the primary cause here. Our results are confirmed for all four health indicators. We conclude that relying on better health to contain healthcare expenditures is too optimistic, and the interaction between health and mortality should be taken into account when projecting healthcare costs. Healthy ageing is important, but more for health gains than for cost savings.
本文研究了八年期间基线健康状况与医院使用成本之间的关系。我们将横断面调查数据与荷兰国家医院登记处的信息相结合。考虑了健康的四个不同指标（自我感知健康、长期损伤、ADL 限制和合并症）。我们发现，在 50 至 70 岁之间，健康状况良好和健康状况不佳的人之间的医院成本差异很大，并且在整个时期内持续存在。然而，对于更高的年龄，预计健康状况不佳的人的预期医院成本会迅速下降，并且在大约六到七年后低于健康状况良好的人的成本。健康状况不佳的人中更高的死亡率是主要原因。我们的结果得到了所有四个健康指标的证实。我们的结论是，依靠更好的健康状况来控制医疗保健支出过于乐观，在预测医疗保健成本时应考虑健康状况和死亡率之间的相互作用。健康老龄化很重要，但与其说可以节省成本，不如说可以获得健康收益。
