Abstract
Japan is currently experiencing the most rapid population aging among all OECD countries. Increasing expenditures on medical care in Japan have been attributed to the aging of the population. Authors in the recent debate on end-of-life care and long-term care (LTC) cost in the United States and Europe have attributed time to death and non-medical care cost for the aged as a source of rising expenditures. In this study, we analyzed a large sample of local public insurance claim data to investigate medical and LTC expenditures in Japan. We examined the impact of aging, time to death, survivorship, and use of LTC on medical care expenditure for people aged 65 and above. On the basis of these findings, we conclude that age is a contributing factor to the rising expenditures on LTC, and that the contribution of aging to rising medical care expenditures should be distinguished according to survivorship.
Highlights
IntroductionPopulation Aging and End-of-Life Medical Care Costs
Rising expenditures on formal services associated with medical and long-term care (LTC) in aging societies has led researchers and policy makers to examine the use of medical services prior to death
Our findings regarding the pattern of medical expenditure divided by LTC use status differ from those reported by Werblow, et al [19]
Summary
Population Aging and End-of-Life Medical Care Costs. An early study of Medicare data in the United States by Lubitz and Prihoda [1] estimated that end-of-life medical expenditures accounted for 28% of the total annual medical expenditures in the country. According to their results, the majority of this amount was spent within one month before death. Other studies using updated Medicare data [2,3] have consistently reported that, in spite of the recent introduction of alternative services such as hospice and homecare, the share of end-of-life medical expenditures has remained almost constant over time. Et al [4] attributed the increase in medical expenditures to an increase in the intensity of treatment under inpatient care offsetting the decrease in in-hospital deaths
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