Ageing, health and retirement in Europe: alternative scenarios for health, life expectancy and social expenditure

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This study deals with the impact of ageing populations and changes in their health status on health care and the utilisation of long-term care services. Two kinds of projection methods have been used to estimate increases up to 2050 in the number of hospital cases and days, contacts with doctors, long-term care recipients and severely hampered persons for Belgium, Denmark, Finland, France, Germany, the Netherlands, Spain and the UK. In the first projection method, health care utilisation data from national sources (which cover the whole population) are combined with two demographic scenarios. This kind of projection shows the impact of demographic change and increasing life expectancy on the utilisation of health care services. In the second projection method, data from the European Community Household Panel are used (which only includes persons aged 16+ but allows differentiation of utilisation data by health status) and combined with four demographic and health scenarios.

The two projection methods generally point to the same findings:

• changes in the number of hospital days and in the demand for long-term care-giving (i.e. the number of severely hampered persons) are likely to be stronger than changes in the number of hospital admissions and contacts with doctors;
• an additional increase in life expectancy leads to higher population figures by 2050, but increases in the utilisation of health care services are more dynamic; and
• for the most part, countries with decreasing populations by 2050 do not show lower increases in the utilisation of health care services than countries with increasing populations.

Improvements in health status lead to a more moderate increase in the utilisation of health care services compared with the scenarios that show no improvements in health. But in general, given the underlying assumptions improvements in health cannot completely compensate for the effect of increasing life expectancy.