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Health, Life Expectancy, and Health Care Spending among the Elderly
Open accessAbstract
BACKGROUND: Life expectancy among the elderly has been improving for many decades, and there is evidence that health among the elderly is also improving. We estimated the relation of health status at 70 years of age to life expectancy and to cumulative health care expenditures from the age of 70 until death. METHODS: Using the 1992-1998 Medicare Current Beneficiary Survey, we classified persons' health according to functional status and whether or not they were institutionalized and according to self-reported health. We used multistate life-table methods and microsimulation to estimate life expectancy for persons in various states of health. We linked annual health care expenditures with transitions between health states. RESULTS: Elderly persons in better health had a longer life expectancy than those in poorer health but had similar cumulative health care expenditures until death. A person with no functional limitation at 70 years of age had a life expectancy of 14.3 years and expected cumulative health care expenditures of about 136,000 dollars (in 1998 dollars); a person with a limitation in at least one activity of daily living had a life expectancy of 11.6 years and expected cumulative expenditures of about 145,000 dollars. Expenditures varied little according to self-reported health at the age of 70. Persons who were institutionalized at the age of 70 had cumulative expenditures that were much higher than those for persons who were not institutionalized. CONCLUSIONS: The expected cumulative health expenditures for healthier elderly persons, despite their greater longevity, were similar to those for less healthy persons. Health-promotion efforts aimed at persons under 65 years of age may improve the health and longevity of the elderly without increasing health expenditures.
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“Research has shown that very old individuals with lower functional capacities face greater healthcare costs than their more physically capable peers [659], with these expenses being notably higher for those in care facilities [672].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [672]
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“Aging is associated with increased healthcare costs, which increase with declining health and functional ability [[672], [673], [674]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [672]
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Cites
Verbrugge, L. M., & Jette, A. M. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90294-1 · Cited by 3,310
Shao, J., & Tu, D. (1995) · Springer Series in Statistics · doi:10.1007/978-1-4612-0795-5 · Cited by 1,985
An epidemiology of disability among adults in the United States.
Nagi, S. Z. (1976) · The Milbank Memorial Fund Quarterly. Health and Society · doi:10.2307/3349677 · Cited by 1,431
Katz, S., Branch, L. G., Branson, M. H., Papsidero, J. A., Beck, J. C., & Greer, D. S. (1983) · New England Journal of Medicine · doi:10.1056/nejm198311173092005 · Cited by 810
Mantón, K. G., & Gu, X. (2001) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.111152298 · Cited by 663
Aging, Health Risks, and Cumulative Disability
Harper, D. W., & Forbes, W. F. (1998) · New England Journal of Medicine · doi:10.1056/nejm199808133390716 · Cited by 515
Aging, Health Risks, and Cumulative Disability
Vita, A. J., Terry, R. B., Hubert, H. B., & Fries, J. F. (1998) · New England Journal of Medicine · doi:10.1056/nejm199804093381506 · Cited by 499
Educational Status and Active Life Expectancy among Older Blacks and Whites
Guralnik, J. M., Land, K. C., Blazer, D. G., Fillenbaum, G. G., & Branch, L. G. (1993) · New England Journal of Medicine · doi:10.1056/nejm199307083290208 · Cited by 485
National Estimates of the Quantity and Cost of Informal Caregiving for the Elderly with Dementia*
Langa, K. M., Chernew, M. E., Kabeto, M. U., Herzog, A. R., Ofstedal, M. B., Willis, R. J., Wallace, R. B., Mucha, L., Straus, W. L., & Fendrick, A. M. (2001) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2001.10123.x · Cited by 456
The Effect of Longevity on Spending for Acute and Long-Term Care
Spillman, B. C., & Lubitz, J. D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005113421906 · Cited by 417
Self-citationPotential and Active Family Caregivers: Changing Networks and the ‘Sandwich Generation’
Spillman, B. C., & Pezzin, L. E. (2000) · Milbank Quarterly · doi:10.1111/1468-0009.00177 · Cited by 306
Understanding trends in functional limitations among older Americans.
Freedman, V. A., & Martin, L. G. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.10.1457 · Cited by 305
Crimmins, E. M., Hayward, M. D., & Saito, Y. (1994) · Demography · doi:10.2307/2061913 · Cited by 293
Differentials in Active Life Expectancy in the Older Population of the United States
Crimmins, E. M., Hayward, M. D., & Saito, Y. (1996) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/51b.3.s111 · Cited by 248
Dying with Cancer: Patients' Function, Symptoms, and Care Preferences as Death Approaches
McCarthy, E. P., Phillips, R. S., Zhong, Z. J., Drews, R. E., & Lynn, J. (2000) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2000.tb03120.x · Cited by 234
Disability trends among elderly persons and implications for the future
Waidmann, T. A., & Liu, K. (2000) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/55.5.s298 · Cited by 212
Cigarette Smoking and Lifetime Medical Expenditures
Hodgson, T. A. (1992) · Milbank Quarterly · doi:10.2307/3350086 · Cited by 199
Singer, B. H., & Manton, K. G. (1998) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.95.26.15618 · Cited by 162
Daviglus, M. L., Liu, K., Greenland, P., Dyer, A. R., Garside, D. B., Manheim, L. M., Lowe, L. P., Rodin, M. B., Lubitz, J. D., & Stamler, J. (1998) · New England Journal of Medicine · doi:10.1056/nejm199810153391606 · Cited by 160
Self-citationNew Methods for Analyzing Active Life Expectancy
Laditka, S. B., & Wolf, D. A. (1998) · Journal of Aging and Health · doi:10.1177/089826439801000206 · Cited by 151
Increasing Longevity and Medicare Expenditures
Miller, T. C. (2001) · Demography · doi:10.1353/dem.2001.0018 · Cited by 134
Land, K. C., Guralnik, J. M., & Blazer, D. G. (1994) · Demography · doi:10.2307/2061887 · Cited by 132
Persistent, Consistent, Widespread, and Robust? Another Look at Recent Trends in Old-Age Disability
Schoeni, R. F., Freedman, V. A., & Wallace, R. B. (2001) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/56.4.s206 · Cited by 120
Gabrel, C. S. (2000) · PubMed · Cited by 113
Matching MCBS (Medicare Current Beneficiary Survey) and Medicare data: the best of both worlds.
Eppig, F. J., & Chulis, G. S. (1997) · PubMed · Cited by 65
The quality of life in the year before death.
Lentzner, H. R., Pamuk, E. R., Rhodenhiser, E. P., ROTHENBERG, R. B., & Powell‐Griner, E. (1992) · American Journal of Public Health · doi:10.2105/ajph.82.8.1093 · Cited by 48
Self-citation
Research works printed but not linked: 3
- Eppig FJ, 1997, Health Care Financ Rev, 18, 211
- Pope AM, Tarlov AR, eds. Disability in America: toward a national agency for prevention. Washington, D.C.: National Academy Press, 1991.
- Vital statistics of the United States, 1995: preprint of volume II, Mortality, part A, section 6: life tables. Hyattsville, Md.: National Center for Health Statistics, 1998. (DHHS publication no. (PHS) 98-1147.)
Cited by
Sorted by citations
Gait speed and survival in older adults.
Studenski, S. (2011) · JAMA · doi:10.1001/jama.2010.1923 · Cited by 4,558
Ageing populations: the challenges ahead
Christensen, K., Doblhammer, G., Rau, R., & Vaupel, J. W. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61460-4 · Cited by 3,011
Telomeres, stem cells, senescence, and cancer
Sharpless, N. E., & DePinho, R. A. (2004) · Journal of Clinical Investigation · doi:10.1172/jci20761 · Cited by 488
Reducing the costs of chronic kidney disease while delivering quality health care: a call to action
on behalf of the European Kidney Health Alliance, Vanholder, R. C., Annemans, L., Brown, E. A., Gansevoort, R. T., Gout-Zwart, J. J., Lameire, N. H., Morton, R. L., Oberbauer, R. W., Postma, M. J., et al. (2017) · Nature Reviews Nephrology · doi:10.1038/nrneph.2017.63 · Cited by 382
Diabetes in older people: new insights and remaining challenges
Sinclair, A. J., Dunning, T. L., & Rodríguez‐Mañas, L. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70176-7 · Cited by 314
Metadata
- Authors
- Lubitz, J., Cai, L., Kramarow, E., & Lentzner, H.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2003-09-11
- Volume
- 349
- Issue
- 11
- Pages
- 1048-1055
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W1967237446
- Cited by
- 513
- References
- 26
- Citations by year
- 2026: 3 · 2025: 17 · 2024: 14 · 2023: 15 · 2022: 15 · 2021: 16 · 2020: 21 · 2019: 19 · 2018: 29 · 2017: 33 · 2016: 32 · 2015: 30 · 2014: 22 · 2013: 25 · 2012: 25
- FWCI
- 55.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Global Health Care Issues
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- life expectancy, health care expenditure, older adults, functional status, activities of daily living, institutionalization, self-reported health, health status, longevity, health promotion, Medicare Current Beneficiary Survey
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Health Expenditures, Persons with Disabilities, Disabled Persons, Health Status, Health Surveys, Humans, Life Expectancy, United States, Life Tables
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