The Old factor

Just catching up on some things.  A few have asked me about an article a couple weeks ago covering some work from Harold on how Pittsburgh’s medicare spending per capita compares to other regions.  In summary read: it’s really high.

It just got me thinking.  Whenever I see anything like this I wonder about the impact of age demographics. I can’t tell from the PG’s coverage if there is a fuller reference to look at as it does not give a specific cite, but I think it all follows directly from the data in the map at the the Dartmouth Atlas .  So this isn’t really intended as a reaction to that article as a general look at what is going on within the elderly population here compared to elsewhere.  Still that map there on the Dartmouth Atlast sure appears to me superficially to have a strong correlation to maps of age in the US; at least that big older swath through Appalachia.  I can’t begin to say much about what is going on in Texas and the Gulf Coast.

Even just looking at the local elderly population it is not quite the same as the elderly populations elsewhere.  I made a graph of how Pittsburgh’s elder population compares to other metropolitan regions.  This is what I get for the breakdown of “Older Old” population, I’ll use the population age 85 and over here, as a propoprtion of the population age 65 and over.

So that is a pretty significant range across metro areas.  Some have much older elderly populations than others. Hard to imagine that does impact expendtures on health care here compared to elsewhere. That would especially be true of a Medicare served population which is older to begin with.  It may be an age factor that is accounted for in the initial benchmarking of this data, I don’t know.
This all would matter in the health care context a lot since at least the economists have worked out that a large chunk of Medicare spending is all tied up in end of life care. So if you have a lot bigger proportion of your population nearing mortality, then you might expect that to show up in the health care costs in aggregate. Since Pittsburgh remains the only large metro area with a natural population decline (more deaths than births) we remain an outlier across a lot these demographics.
Just to think about is all.

1 comment to The Old factor

  • Jon Skinner

    All of the Dartmouth Atlas measures already adjust for age, sex, race, and price differences. So variation across regions in age cannot explain the Atlas spending variations. A much higher mortality rate (conditional on age) in Pittsburgh could explain some of the difference, but not much, as the over-65 mortality rate there is only somewhat elevated over the national average.

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