Jona T Stahmeyer1, Sascha Hamp2, Jan Zeidler3, Sveja Eberhard4. 1. Stabsbereich Versorgungsforschung, Bereich Politik, Forschung, Presse, AOK Niedersachsen, Hildesheimer Str. 273, 30519, Hannover, Deutschland. Jona.Stahmeyer@nds.aok.de. 2. Bereich Versorgungs- und Kontaktmanagement, AOK Niedersachsen, Hannover, Deutschland. 3. Center for Health Economic Research Hannover (CHERH)/Institut für Gesundheitsökonomie, Leibniz Universität Hannover, Hannover, Deutschland. 4. Stabsbereich Versorgungsforschung, Bereich Politik, Forschung, Presse, AOK Niedersachsen, Hildesheimer Str. 273, 30519, Hannover, Deutschland.
Abstract
BACKGROUND: Germany faces various socio-political challenges due to its ongoing ageing population. Significant increases in social security contributions are widely expected. The impact of ageing on healthcare expenditure is a controversial issue. Experts agree that costs for end-of-life care account for a significant part of total healthcare expenditures. For a meaningful forecast, detailed information on healthcare costs differentiated by survivors and decedents is necessary. Extensive data are hardly available for Germany. The aim of the analysis was therefore to describe healthcare costs in the statutory health insurance. METHODS: The basis for the calculation is billing data from the statutory health insurance "AOK Niedersachsen" (Lower Saxony). Persons who survived or died in 2017 were included in the analysis. Average costs were standardised. RESULTS: The data of 2.46 million survivors and 34,307 decedents were analysed. The average annual healthcare costs were 2756 € for survivors and 21,830 € for decedents in the last year of life. The average healthcare costs for survivors increase with age whereas costs for decedents are highest in younger age groups and decline with increasing age. A detailed analysis of end-of-life costs shows an exponential increase of costs in the last three years of life with the highest costs in the quarter before death (10,577 €). DISCUSSION: The analysis gives a detailed overview on the structure of healthcare expenditure in the statutory health insurance and can serve as a basis for future forecasts regarding healthcare expenditure.
BACKGROUND: Germany faces various socio-political challenges due to its ongoing ageing population. Significant increases in social security contributions are widely expected. The impact of ageing on healthcare expenditure is a controversial issue. Experts agree that costs for end-of-life care account for a significant part of total healthcare expenditures. For a meaningful forecast, detailed information on healthcare costs differentiated by survivors and decedents is necessary. Extensive data are hardly available for Germany. The aim of the analysis was therefore to describe healthcare costs in the statutory health insurance. METHODS: The basis for the calculation is billing data from the statutory health insurance "AOK Niedersachsen" (Lower Saxony). Persons who survived or died in 2017 were included in the analysis. Average costs were standardised. RESULTS: The data of 2.46 million survivors and 34,307 decedents were analysed. The average annual healthcare costs were 2756 € for survivors and 21,830 € for decedents in the last year of life. The average healthcare costs for survivors increase with age whereas costs for decedents are highest in younger age groups and decline with increasing age. A detailed analysis of end-of-life costs shows an exponential increase of costs in the last three years of life with the highest costs in the quarter before death (10,577 €). DISCUSSION: The analysis gives a detailed overview on the structure of healthcare expenditure in the statutory health insurance and can serve as a basis for future forecasts regarding healthcare expenditure.
Authors: Katharina van Baal; Sophie Schrader; Nils Schneider; Birgitt Wiese; Jona Theodor Stahmeyer; Sveja Eberhard; Siegfried Geyer; Stephanie Stiel; Kambiz Afshar Journal: BMC Palliat Care Date: 2020-12-08 Impact factor: 3.234