Population aging and medical cost growth—From the perspective of medical cost concentration and Sustainability

Zhang Yue, Xigang Qin
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Abstract

This paper examines the causes of increasing medical expenses caused by population aging from the aspects of concentration and sustainability. Counterfactual calculation shows that the important fact that population aging increases medical expenses at different quantiles and reduces the distribution gap of medical expenses is rooted in the high concentration and strong sustainability of medical expenses of the elderly population. The medical expenses of the elderly population not only have the characteristics of high single hospitalization expenses, large proportion of continuous hospitalization and strong dispersion of medical expenses, but also have a heavier expenditure burden in the five medical expense levels. The influence of population aging on the growth of medical expenses is lower than that of the change of age structure of the whole population. The influence of endowment effect increases with time, and the increase of high score medical expenses is the most obvious. In addition, the improvement of health awareness plays a leading role in the structural effect affecting the growth of medical expenses. By constructing the theoretical logic that the medical needs of the elderly population affect the medical expenses, this paper strongly explains the reality of the rapid growth of medical expenses under the background of China’s aging population.
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人口老龄化与医疗成本增长——基于医疗成本集中度与可持续性的视角
本文从集中度和可持续性两个方面探讨了人口老龄化导致医疗费用增加的原因。反事实计算表明,人口老龄化在不同分位数上增加了医疗费用,缩小了医疗费用分配差距,这一重要事实植根于老年人口医疗费用的高度集中和较强的可持续性。老年人群的医疗费用不仅具有单次住院费用高、连续住院比例大、医疗费用分散性强的特点,而且在五个医疗费用水平中支出负担更重。人口老龄化对医疗费用增长的影响小于整个人口年龄结构变化的影响。养老效应的影响随着时间的推移而增加,其中高分医疗费用的增加最为明显。此外,健康意识的提高在影响医疗费用增长的结构效应中起主导作用。通过构建老年人口医疗需求影响医疗费用的理论逻辑,有力地解释了中国人口老龄化背景下医疗费用快速增长的现实。
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