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Data Support Basing Health Decisions on Both Benefit, Cost

FRIDAY, May 24 (HealthDay News) -- Person-level health care expenditures per month of health status-adjusted life expectancy are much higher for adults aged 85 years and older than for 0- to 14-year-olds, but despite spending much more on health care, the aging population gets substantially less value for that spending in terms of quality and quantity of life expectancy, according to a study published in the Spring issue of the Michigan Journal of Public Affairs.

Matthew M. Davis, M.D., and Adam T. Swinburn, M.P.P., from the University of Michigan in Ann Arbor, used data from the 2008 National Health Interview Survey to estimate health care spending associated with gains in health status-adjusted life expectancy for individuals of different ages.

The researchers found that, overall, older Americans have markedly worse health compared with younger adults and children, with additional years of life for older people being perceived as less valuable by the individuals living them, compared to years of life experienced by younger people. They also found that as the U.S. population ages, much more is spent on health care but with substantially less value for that spending, in terms of quality and quantity of life expectancy. They found that after adjustment for morbidity there was a decrease in the value of remaining life expectancy of 5.6 years for those aged 0 to 14 years (8 percent of unadjusted life expectancy) and of 0.9 years for those aged 85 years and older (17 percent of unadjusted life expectancy). Per month of health status-adjusted life expectancy, person-level health care expenditures varied from $2 for the youngest age group to $224 for those aged 85 years and older.

"In an age of real and threatened cuts to public programs, our findings suggest that reducing spending on health care for younger populations would impinge on utility in the U.S. population more than reducing spending on health care for older populations," the authors write. "In terms of possible budget solutions proposed, our analysis suggests that constraining Medicare eligibility or benefits -- whether or not a sound decision from other points of view -- would be more appropriate than limiting the Medicaid expansion envisioned in the Affordable Care Act."

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