‘More Than One Red Herring'? Heterogeneous Effects of Ageing on Healthcare Utilisation

Cristina Vilaplana-Prieto
University of Murcia

Abstract

We study the effect of ageing, defined an extra year of life, on healthcare utilisation, disentangling such effect from other alternative explanations such as the presence of comorbidities and endogenous time to death (TTD). We exploit individual level longitudinal end of life data from several European countries that contains records of medicines use, outpatient and inpatient care as well as long-term care. We report three sets of findings. First, corrected TTD estimates are significantly different from uncorrected ones, and influence the effect of both the extensive and intensive margin of hospital admissions and length of stay, as well as home and nursing home care use consistently with a ‘red herring hypothesis’. Second, the effect size of TTD exceeds that of an extra year of life, which in turn is moderated by individual comorbidities. Finally, corrected estimates suggest an overall moderate effect of ageing, which does not influence (both the internal and external margins of) outpatient care utilisation. These results suggest the presence of ‘more than one red herring’ depending on the type of healthcare examined


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