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Previous Volume 355:920-927 August 31, 2006 Number 9 Next

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ABSTRACT

Background The increased use of medical therapies has led to increased medical costs. To provide insight into the value of this increased spending, we compared gains in life expectancy with the increased costs of care from 1960 through 2000.

Methods We estimated life expectancy in 1960, 1970, 1980, 1990, and 2000 for four age groups. To control for the influence of nonmedical factors on survival, we assumed in our base-case analysis that 50 percent of the gains were due to medical care. We compared the adjusted increases in life expectancy with the lifetime cost of medical care in the same years.

Results From 1960 through 2000, the life expectancy for newborns increased by 6.97 years, lifetime medical spending adjusted for inflation increased by approximately $69,000, and the cost per year of life gained was $19,900. The cost increased from $7,400 per year of life gained in the 1970s to $36,300 in the 1990s. The average cost per year of life gained in 1960–2000 was approximately $31,600 at 15 years of age, $53,700 at 45 years of age, and $84,700 at 65 years of age. At 65 years of age, costs rose more rapidly than did life expectancy: the cost per year of life gained was $121,000 between 1980 and 1990 and $145,000 between 1990 and 2000.

Conclusions On average, the increases in medical spending since 1960 have provided reasonable value. However, the spending increases in medical care for the elderly since 1980 are associated with a high cost per year of life gained. The national focus on the rise in medical spending should be balanced by attention to the health benefits of this increased spending.

Source Information

From the Department of Economics, Harvard University, and the National Bureau of Economic Research — both in Cambridge, Mass. (D.M.C.); and the Center for Practice Management and Outcomes Research, Ann Arbor Veterans Affairs Medical Center, and the Division of General Medicine, University of Michigan Health System — both in Ann Arbor (A.B.R., S.V.).

Address reprint requests to Dr. Cutler at the Department of Economics, Harvard University, 1875 Cambridge St., Cambridge, MA 02138, or at dcutler{at}harvard.edu.

Full Text of this Article

Related Letters:

The Value of Medical Spending in the United States
Barr D. A., Goozner M., Braithwaite R. S., Roberts M. S., Cutler D. M., Rosen A. B., Vijan S.
Extract | Full Text | PDF  
N Engl J Med 2006; 355:2491-2492, Dec 7, 2006. Correspondence

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