Wang Fuhmei, Wang Jung-Der
Department of Economics in College of Social Science and Department of Public Health in College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan.
Health Econ Rev. 2021 Jun 4;11(1):18. doi: 10.1186/s13561-021-00321-3.
The proportion of the elderly aged 65 years old or above will reach 16% in 2050 worldwide. Early investment in effective prevention would generally reduce the morbidity, complication, functional disability, and mortality of most chronic illnesses and save resources in both healthcare and social services. This research aims to investigate how the optimal allocation of medical resources between prevention and treatment adds value to the population's health as well as examine the interaction between ageing, health, and economic performance.
This research undertakes ageing-health analyses by developing an economic growth model. Based on the Organization for Economic Co-Operation and Development (OECD) countries' experiences over the period from 2000 to 2017, this research further examines the hypothesis that an ageing society could increase demand for preventive and curative healthcare.
Theoretical analysis found that the prevention share for maximizing growth is the same as that for minimizing ill health and maximizing welfare; this share increases with treatment share and ageing ratios. Estimation results from OECD countries' experiences indicate that when treatment share increases by 1%, the prevention demand increases by 0.036%. A one-percent increase in the ageing ratio yields a change in prevention share of 0.0368%. The optimal share of prevention health expenditure to GDP would be 1.175% when the prevalence rate of ill health isat 6.13%; a higher or lower share of prevention would be accompanied with a higher prevalence of ill health. For example, a zero and 1.358% preventive health expenditure would be associated with an 18.01% prevalence of ill health, while the current share of prevention of 0.237% is associated with a 10.26% prevalence of ill health.
This study shows that appropriate prevention is associated with decreases in the prevalence rates of ill health, which in turn attains sustainable growth in productivity. Too much prevention, however, could lead to higher detection of new chronic diseases with mild severity, which would result in longer illness duration, and higher prevalence rates of ill health. With suitable allocation of medical resources, the economic growth rate will help to cancel out increases in healthcare spending for the elderly and for expenses needed for the improvement of the population's health as a whole.
到2050年，全球65岁及以上老年人的比例将达到16%。对有效预防进行早期投资通常会降低大多数慢性病的发病率、并发症、功能残疾率和死亡率，并节省医疗保健和社会服务方面的资源。本研究旨在调查预防和治疗之间医疗资源的最优分配如何为人群健康增加价值，并研究老龄化、健康和经济表现之间的相互作用。
本研究通过建立经济增长模型进行老龄化与健康分析。基于经济合作与发展组织（经合组织）国家2000年至2017年期间的经验，本研究进一步检验老龄化社会会增加对预防性和治疗性医疗保健需求这一假设。
理论分析发现，使增长最大化的预防份额与使健康不佳最小化和福利最大化的预防份额相同；该份额随治疗份额和老龄化比率的增加而增加。经合组织国家经验的估计结果表明，当治疗份额增加1%时，预防需求增加0.036%。老龄化比率每增加1%，预防份额的变化为0.0368%。当健康不佳患病率为6.13%时，预防健康支出占国内生产总值的最优份额为1.175%；预防份额过高或过低都会伴随着更高的健康不佳患病率。例如，零预防健康支出和1.358%的预防健康支出将分别与18.01%的健康不佳患病率相关联，而目前0.237%的预防份额与10.26%的健康不佳患病率相关联。
本研究表明，适当的预防与健康不佳患病率的降低相关，这反过来又能实现生产力的可持续增长。然而，过多的预防可能导致更多轻度新慢性病被检出，这将导致更长的患病时间和更高的健康不佳患病率。通过适当分配医疗资源，经济增长率将有助于抵消老年人医疗保健支出的增加以及改善总体人群健康所需费用的增加。
