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人口老龄化对医疗保健支出的影响:基于意大利数据的贝叶斯向量自回归分析

The effects of population ageing on health care expenditure: A Bayesian VAR analysis using data from Italy.

作者信息

Lopreite Milena, Mauro Marianna

机构信息

Scuola Superiore Sant'Anna di Pisa, Institute of Economics, Piazza dei Martiri della Libertà, 3-56127 Pisa, Italy.

University Magna Graecia of Catanzaro, Department of Clinical and Experimental Medicine, Viale Europa, 88100 Germaneto, Italy.

出版信息

Health Policy. 2017 Jun;121(6):663-674. doi: 10.1016/j.healthpol.2017.03.015. Epub 2017 Mar 31.

Abstract

Currently, the dynamics of the population have raised concerns about the future sustainability of Italy's national health system. The increasing proportion of people over the age of 65 could lead to a higher incidence of chronic-degenerative diseases and a greater demand for health and social care with a consequent impact on health spending. Although in recent years the quantity and quality of works on the relationship between ageing and health expenditure has increased substantially these works do not always obtain similar results. Starting from this point, we use a B-VAR model and Eurostat data to investigate over the period 1990-2013 the impact of demographic changes on health expenditure in Italy. We estimate these models using impulse-response analysis and variance decomposition. The results show that health expenditure in Italy reacts more to the ageing population compared with life expectancy and per capita GDP. In response to these findings, we conclude that the impact of the increase in the elderly population with disabilities will fall on the long-term care sector. Effective health interventions, such as health-promotion and disease-prevention programs that target the main causes of morbidity, could help to minimize the cost pressures associated with ageing by ensuring that the population stays healthy in old age. We consider the implications of this work for health care policy suggestions and for future research.

摘要

目前,人口动态变化引发了人们对意大利国家卫生系统未来可持续性的担忧。65岁以上人口比例的增加可能导致慢性退行性疾病发病率上升,对医疗和社会护理的需求也会更大,从而对医疗支出产生影响。尽管近年来关于老龄化与医疗支出之间关系的研究在数量和质量上都有了大幅提升,但这些研究结果并不总是一致。基于此,我们使用B-VAR模型和欧盟统计局的数据,对1990年至2013年期间意大利人口结构变化对医疗支出的影响进行调查。我们使用脉冲响应分析和方差分解对这些模型进行估计。结果表明,与预期寿命和人均国内生产总值相比,意大利的医疗支出对人口老龄化的反应更为敏感。针对这些研究结果,我们得出结论,残疾老年人口增加带来的影响将落在长期护理部门。有效的健康干预措施,如针对发病主要原因的健康促进和疾病预防计划,通过确保人们在老年时保持健康,有助于将与老龄化相关的成本压力降至最低。我们考虑了这项工作对医疗政策建议和未来研究的影响。

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