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PAPERS: Willem Jan Meerding, Luc Bonneux, Johan J Polder, Marc A Koopmanschap, and Paul J van der Maas Demographic and epidemiological determinants of healthcare costs in Netherlands: cost of illness study BMJ 1998; 317: 111-115 [Abstract] [Full text]

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Ageing is not the main factor in costs

Charles Normand   (16 July 1998)

Ageing is not the main factor in costs 16 July 1998
Charles Normand, Professor of Health Policy London School of Hygiene and Tropical Medicine, (on sabbatical at Univerity of British Columbia) Send response to journal: Re: Ageing is not the main factor in costs	This paper reports on an excellent study, which provides very valuable information on patterns of costs. However, the authors draw conclusions that are not justified, and other evidence suggests may be wrong. A body of literature shows that for acute medical care proximity to death is more important than age as a factor in determining costs (eg. Lubitz and Riley 1993). It is clear that nursing home costs are high for elderly people, but there is little evidence that this is growing rapidly. We need to be very cautious about extrapolation from cross sectional studies to the effects of ageing and suggesting dramtic effects (Barer et al 1995). They are much more complicated. Ref Lubitz J.G. and Riley G.F (1993) Trends in medicare payments in the last year of life. New England Journal of Medicine 328:1092-1096 Barer M.L., Evans R.G. and Hertzman C (1995) Avalanche or Glacier?: Health Care and the Demographic Rhetoric. Canadian Journal on Aging 14:193-224