老龄化、临近死亡与医疗支出

Aging, Time-to-Death and Health Care Expenditure

目的:分析个体微观层面下年龄、临近死亡对医疗支出的影响。方法:利用2011年和2013年中国健康与养老追踪调查数据(CHARLS),通过构建两步估计模型分析临近死亡对医疗支出的影响。结果:当临近死亡时,伴随着年龄的增长医疗支出会出现先增长然后下降的趋势,即实际死亡年龄越高,其平均医疗费用支出反而越低。结论:临近死亡因素是影响医疗支出的显著因素,临近死亡时医疗支会出现显著的增加。具体到临近死亡时间,临近死亡1年和临近死亡两年对医疗支出的影响显著,临近死亡3年的影响不显著,而年龄对于医疗支出的影响不再显著。结论:老龄化背景下虽然由于老年人口比例的上升会给整个社会带来巨大的医疗支出负担,但不能简单的将老龄化与医疗支出上涨相联系,更不能过度夸大老龄化对医疗支出上涨的作用。

Objective： To investigate the impact of time-to-death（TTD） on the health care expenditure of elderly people. Methods： Using 2011 and 2013 China Health and Retirement Longitudinal Survey（CHARLS） data to construct a two step estimation model so as to analyze the influence of near death on medical expenditure. Results： TTD was a significant factor for medical expenditure. For the period of time to death, there was a significant increase followed by a decrease in the health care expenditure as the patient aged. The higher the age of patient was, the lower the medical cost was. Conclusion： Although the increase of elderly population would bring enormous medical burden to the whole society, it was not easy to link the aging and medical expenses rise. The role of aging on the rise of health care expenditure should not be exaggerated.