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General

Needs and health care costs in old age: a longitudinal perspective: results from the AgeMooDe study

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Pages 1763-1768 | Received 17 May 2019, Accepted 03 Sep 2019, Published online: 08 Oct 2019
 

Abstract

Background: The current study aimed to identify whether needs are associated with health care costs in late life longitudinally.

Methods: Data were gathered from two waves (at baseline, n = 1199; at follow-up, n = 958) of a multicenter prospective cohort study (‘Late-life depression in primary care: needs, health care utilization and costs’, AgeMooDe) in Germany. Individuals aged 75 years and above were recruited via general practitioners. The ‘Camberwell Assessment of Need for the Elderly’ (CANE) was used to assess needs. Based on a questionnaire, the health-related resource use was assessed retrospectively from a societal perspective. The assessment covered outpatient services, inpatient treatment, pharmaceuticals, as well as formal and informal nursing care. Random effects regressions were used.

Results: Regressions showed that the number of ‘no needs’ is inversely associated with total health care costs from a societal perspective (β = –584.0, p < .001). When a health care perspective was adopted, this association was also significant (β = –298.8, p < .001). The association between needs and health care costs persisted in all health care sectors considered in this study.

Limitations: It might be difficult to generalize our findings to individuals residing in institutional settings.

Conclusion: Adjusting for several potential confounders (e.g. sociodemographic and health-related factors), our study showed that needs – quantified using the CANE – are important for health care costs. Interventions should be developed to reduce needs in late life. These interventions may be beneficial for the health care system.

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

This study was funded by the German Federal Ministry of Education and Research (BMBF, grant number: 01GY1155A) and the Federal Ministry of Health (BMG, grant number: II A 5 - 2513 FSB 014). The publication was also supported by the study ‘Healthy Aging: Gender specific trajectories into latest life’ (AgeDifferent.De) that was funded by the German Federal Ministry of Education and Research (grants 01GL1714A; 01GL1714B; 01GL1714C; 01GL1714D).

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