The world population has been experiencing significant ageing -the process that results in rising proportions of older persons in the total population- since the mid-twentieth century. Driven by falling fertility rates and remarkable increases in life expectancy, population aging will continue, even accelerate. The number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries. The remarkable improvements in life expectancy over the past century were part of a shift in the leading causes of disease and death. At the dawn of the 20th century, the major health threats were infectious and parasitic diseases that most often claimed the lives of infants and children. Currently, noncommunicable diseases that more commonly affect adults and older people impose the greatest burden on global health. In the economic policy debate it is often stated that population ageing will lead to huge increases in the age-related components of public expenditure – primarily pensions and health care. Over the next 50 years, most of the countries will experience a steep increase in the share of elderly persons in the population and a large decline in the share of the population of prime working-age. Consequently, the number of workers retiring each year will increase sharply and eventually exceed the number of new labour market entrants. Population aging is therefore likely to influence patterns of pensions and health care spending in both developed and developing countries in the decades to come. In developed countries, where acute care and institutional long-term care services are widely available, the use of medical care services by adults rises with age, and per capita expenditures on health care are relatively high among older age groups. Accordingly, the rising proportion of older people is placing upward pressure on overall health care spending in the developed world, although other factors such as income growth and advances in the technological capabilities of medicine generally play a much larger role. Some papers anyway analyses a factor that may, at least partly, alleviate the fear that increased life expectancy will accelerate the rise in health-care spending: namely the fact that independent of decedent age, the bulk of per capita health-care costs are concentrated in the last years of life (the so-called ‘death-related’ costs).
La popolazione mondiale sta attraversando un periodo di significativo invecchiamento, il processo che si traduce in un aumento della percentuale di persone anziane rispetto alla popolazione totale, sin dalla metà del ventesimo secolo. Guidato dal forte calo del tasso di fecondità e da un notevole aumento dell’aspettativa di vita, l'invecchiamento della popolazione continuerà ed accelererà nei prossimi anni. Il numero di persone di età superiore ai 65 anni è destinato a crescere dai 524 milioni stimati nel 2010 ai quasi 1,5 miliardi nel 2050. I notevoli miglioramenti dell’aspettativa di vita registrati nel secolo scorso sono dovuti principalmente ad un cambiamento nelle principali cause di malattia e di morte. All'alba del ventesimo secolo, le principali minacce per la salute erano costituite dalle malattie infettive e parassitarie che colpivano prevalentemente neonati e bambini. Attualmente sono invece le malattie non trasmissibili che riguardano più comunemente gli adulti e gli anziani ad incidere maggiormente sulla salute globale. Nel dibattito di politica economica si è spesso affermato che l'invecchiamento della popolazione porterà ad un enorme aumento della spesa pubblica, soprattutto per quanto riguarda le pensioni e l'assistenza sanitaria. Nel corso dei prossimi 50 anni, molti Paesi subiranno un forte aumento della percentuale di persone anziane e un calo della quota della popolazione in età lavorativa. Di conseguenza il numero pensionati aumenterà di anno in anno fino quasi a superare il numero di nuovi operatori del mercato del lavoro. Per quanto riguarda la sanità, nei Paesi sviluppati, dove le cure per acuti e i servizi di assistenza a lungo termine sono ampiamente diffusi, la spesa pro capite per l'assistenza sanitaria aumenta con l’età. Di conseguenza la percentuale crescente di persone anziane metterà sempre più sotto pressione la spesa complessiva per l'assistenza sanitaria, nonostante la crescita del reddito e i progressi tecnologici della medicina rimangono i principali determinanti della spesa sanitaria. Alcuni studi sottolineano comunque un fattore che può, almeno in parte, alleviare il timore che l'aumento della speranza di vita sia la causa principale dell'aumento della spesa sanitaria: la maggior parte dei costi sanitari pro capite si concentra infatti negli ultimi anni di vita, indipendentemente dall’età.
Invecchiamento della popolazione e costi sanitari legati alla morte
POZZATO, MATTEO
2015/2016
Abstract
The world population has been experiencing significant ageing -the process that results in rising proportions of older persons in the total population- since the mid-twentieth century. Driven by falling fertility rates and remarkable increases in life expectancy, population aging will continue, even accelerate. The number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries. The remarkable improvements in life expectancy over the past century were part of a shift in the leading causes of disease and death. At the dawn of the 20th century, the major health threats were infectious and parasitic diseases that most often claimed the lives of infants and children. Currently, noncommunicable diseases that more commonly affect adults and older people impose the greatest burden on global health. In the economic policy debate it is often stated that population ageing will lead to huge increases in the age-related components of public expenditure – primarily pensions and health care. Over the next 50 years, most of the countries will experience a steep increase in the share of elderly persons in the population and a large decline in the share of the population of prime working-age. Consequently, the number of workers retiring each year will increase sharply and eventually exceed the number of new labour market entrants. Population aging is therefore likely to influence patterns of pensions and health care spending in both developed and developing countries in the decades to come. In developed countries, where acute care and institutional long-term care services are widely available, the use of medical care services by adults rises with age, and per capita expenditures on health care are relatively high among older age groups. Accordingly, the rising proportion of older people is placing upward pressure on overall health care spending in the developed world, although other factors such as income growth and advances in the technological capabilities of medicine generally play a much larger role. Some papers anyway analyses a factor that may, at least partly, alleviate the fear that increased life expectancy will accelerate the rise in health-care spending: namely the fact that independent of decedent age, the bulk of per capita health-care costs are concentrated in the last years of life (the so-called ‘death-related’ costs).| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/124581