Bjørner Thomas Bue, Arnberg Søren
Danish Economic Councils, Copenhagen K, Denmark.
Int J Health Care Finance Econ. 2012 Jun;12(2):129-43. doi: 10.1007/s10754-012-9106-1. Epub 2012 Mar 11.
This paper presents an empirical analysis of public health expenditure on individuals in Denmark. The analysis separates out the individual effects of age and proximity to death (reflecting terminal costs of dying) and employs unique micro data from the period 2000 to 2009, covering a random sample of 10% of the Danish population. Health expenditure includes treatment in hospitals, subsidies to prescribed medication and health care provided by general practitioners and specialists and covers about 80% of public health care expenditure on individuals. The results confirm findings from previous studies showing that proximity to death has a significant impact on health care expenditure. However, it is also found that cohort effects (the baby boom generation) as well as improvements in life expectancy have a substantial effect on future health care expenditure even when proximity to death is controlled for. These results are obtained by combining the empirical estimates with a long term population forecast. When life expectancy increases, terminal costs are postponed but the increases in health expenditure that follow from longer life expectancy are not as large as the increase in the number of elderly persons would suggest (due to "healthy ageing"). Based on the empirical estimates, healthy ageing is expected to reduce the impact of increased life expectancy on real health expenditure by 50% compared to a situation without healthy ageing.
本文对丹麦的公共卫生个人支出进行了实证分析。该分析分离出了年龄和接近死亡程度（反映临终成本）的个体效应，并采用了2000年至2009年期间独特的微观数据，涵盖了丹麦10%人口的随机样本。卫生支出包括医院治疗、处方药补贴以及全科医生和专科医生提供的医疗保健，约占公共卫生个人支出的80%。研究结果证实了先前研究的发现，即接近死亡程度对医疗保健支出有重大影响。然而，研究还发现，即使控制了接近死亡程度，队列效应（婴儿潮一代）以及预期寿命的提高对未来医疗保健支出也有重大影响。这些结果是通过将实证估计与长期人口预测相结合得出的。当预期寿命增加时，临终成本会推迟，但预期寿命延长带来的卫生支出增加幅度并不像老年人口数量增加幅度那么大（由于“健康老龄化”）。基于实证估计，与没有健康老龄化的情况相比，预计健康老龄化将使预期寿命增加对实际卫生支出的影响降低50%。
