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Competing Demographic Drivers of Hospital Expenditures: Coexistence of the Red Herring and the Steepening Effects.

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Τίτλος: Competing Demographic Drivers of Hospital Expenditures: Coexistence of the Red Herring and the Steepening Effects.
Συγγραφείς: Kallestrup-Lamb M; Aarhus University and PeRCent, Aarhus, Denmark., Marin AOK; University of Southern Denmark, CPop, Odense, Denmark., Søgaard J; University of Southern Denmark, CPop, Odense, Denmark.
Πηγή: Health economics [Health Econ] 2026 Jun; Vol. 35 (6), pp. 929-946. Date of Electronic Publication: 2026 Mar 07.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley Country of Publication: England NLM ID: 9306780 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-1050 (Electronic) Linking ISSN: 10579230 NLM ISO Abbreviation: Health Econ Subsets: MEDLINE
Imprint Name(s): Original Publication: Chichester ; New York : Wiley, c1992-
Ιατρικοί όροι (MeSH): Health Expenditures*/statistics & numerical data , Demography*, Humans ; Denmark ; Female ; Aged ; Models, Econometric ; Male ; Aging ; Aged, 80 and over ; Middle Aged ; Age Factors
Περίληψη: The fiscal sustainability of healthcare systems is increasingly strained by aging populations with two competing hypotheses dominating the literature. The Red Herring Hypothesis suggests that healthcare expenditures are driven more by proximity to death than by chronological age, while the Steepening Hypothesis examines whether expenditures increase faster for older individuals over time. Nevertheless, these two frameworks have traditionally been studied independently rather than in conjunction. This paper offers a unified econometric model, allowing for a rigorous assessment of their concurrent validity and interaction. Using comprehensive register-based monthly somatic hospital expenditure data for the entire Danish population from 2002 to 2017, we provide robust evidence that both Red Herring and Steepening effects operate simultaneously. Although Red Herring effects modestly mitigate the expenditure burden of an increasingly older population, they are substantially outweighed by pronounced Steepening effects, which account for nearly 60% of hospital expenditure growth during the observation period. Through a novel decomposition method, we identify a previously unrecognized interaction between these phenomena, a Red Herring Steepening effect, which accelerates expenditure growth in the final years of life for older individuals. Our findings suggest that healthcare systems face considerably greater fiscal challenges from population aging than previously recognized under the Red Herring Hypothesis alone.
(© 2026 The Author(s). Health Economics published by John Wiley & Sons Ltd.)
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Grant Information: Rockwool Fonden
Contributed Indexing: Keywords: Red Herring; Steepening; expenditure decomposition; hospital expenditures; population aging
Entry Date(s): Date Created: 20260307 Date Completed: 20260710 Latest Revision: 20260710
Update Code: 20260711
PubMed Central ID: PMC13126104
DOI: 10.1002/hec.70092
PMID: 41793724
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1099-1050
DOI:10.1002/hec.70092