<p>This report was undertaken to review recent evidence about the changing pattern of health expectancy, that is the length of<p><p>time a person lives in good or ill health, and to examine whether it is likely that this will: \ud \ud <p><p><p>1) affect projections of future long term care (LTC) costs, either up or down; \ud \ud <p><p><p>2) have other policy implications for long-term care costs, for example across modes of care. \ud \ud <p><p><p>Estimates of these costs are not developed in this report, which is a review describing what evidence is available about trends, and what should be taken into consideration when estimates of future costs are developed. Many of the examples are chosen from the UK, though work in France, Netherlands, Australia and elsewhere is cited. The most advanced research in this area comes from the USA and this is referenced particularly where no equivalent exists. However, it is intended that the general conclusions will be applicable to most OECD countries. \ud \ud <p><p><p>The costs of providing long-term care is a matter of increased concern globally, primarily as a result of the fall in mortality, which in particular increases the number of elderly people, and hence the overall prevalence of chronic health conditions. \ud \ud <p><p><p>The usual approach to estimating the future costs of long-term care has been to apply to future population projections, estimates of current age-specific cost rates, or possibly current age-specific utilization rates for treatments and services combined with predictions about future prices. This approach has been used by even sophisticated models such as the HCFA health model, when it has been applied to the question of predicting the implications of an aging population (Burner et al, 1992). However, costs will not necessarily increase pro rata with trends in the numbers of elderly people. The premise of this report is that the relationship between age and long term care need may change
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