Socio-Demographic and Clinical Determinants of Hospital Costs: Evidence from European Countries

Research motivation: Limited financial resources allocated for hospitalized older patients represent a significant economic problem both on public health systems and their families. This study addresses an empirical gap in the literature concerning the determinants of hospital costs in the group of older patients using the SHARE database. Methodology: Socio-demographic and clinical variables as the possible factors that may influence the hospital high cost were considered. The analysis included 9,671 patients, who were hospitalized in 2015. Main findings: On the studied population, 873 patients were identified as CO (cost outliers). The highest share of CO was in Switzerland (12,65%) and the lowest in Italy (5,80%). We found that individuals permanently sick or disabled, who suffered from cancer, diabetes, heart attack or chronic lung disease were associated with being hospital cost outliers. Individuals who reported difficulties with walking 100 m are more often cost outliers. The risk of being a cost outlier increased by 20% with each day spend in hospital. We did not find age and gender to be associated with being high cost outliers. Implications: Action is needed to improve the efficiency of hospitals and community services and improve the coordination of care, especially for older people with comorbidities. A clear understanding of the drivers of high inpatient costs of older patients is essential for developing and implementing policies aimed at improving the efficiency of public expenditure. Interventions aimed at promoting disease prevention and physical activity are also needed.