After the death of a spouse, health care expenditure levels rise by almost half, according to research by Herbert Rolden, PhD student at Leyden Academy on Vitality and Ageing. The research Changes in health care expenditure after the loss of a spouse: Data on 6,487 older widows and widowers in the Netherlands provides insight into the economic value that spousal informal care represents in the Netherlands.
Elderly married couples take care of each other as their health gradually starts to fail. To understand the economic value of this type of informal care, Rolden investigated the health care expenditure through time for 6.487 Dutch widows and widowers aged 65 and older over the period from July 2007 until the end of 2010, in up to 42 months before and after the death of the spouse. After the loss of the spouse, monthly health care expenditure for the widow or widower rose on average by EUR 239 per month (+48%). Overall, the rise sets in at the month someone becomes widowed, and is highest for men (EUR 319; +59%) and widows and widowers aged 80 and older (EUR 553; +82%). Bereavement plays a minor role in the association between widowhood and health care expenditure. Herbert Rolden: "We see no peak in expenditure in the months directly after the death of the spouse. Also, the increase in health care expenditure is five times higher in the long-term care sector than the medical care sector. This suggests that expenditure levels predominantly rise because there is a higher need for formal care after the loss of an informal care-giver, rather than a higher need for medical treatment related to the health impact of bereavement and sorrow."
Economic value of informal care
In view of the increasing number of senior citizens in the Netherlands, it is important to better understand health care expenditure and the economic value of spousal informal care. This can be estimated by observing the difference in health care expenditure by people with a spouse with that of people who have no spouse, or no longer have a spouse. Rolden: "By offering informal care, people keep their partners, family members, friends or neighbours away from the health care sector. The most common type of informal care is from spouse to spouse, particularly wives taking care of their husbands. Since this type of caregiving is unpaid, it is rarely included in economic health care analysis. We have therefore investigated the impact of the death of the spouse on health care expenditure through time. We collected figures of individual health care expenditure within a large population over a long period of time from the database of a Dutch health care insurer, and linked this information with data on marital status."
Intervention programmes
Insight into the economic value of formal care prevention by spouses is important for policy-makers who are concerned with improving the lives of older people and who are, at the same time, obliged to curtail ever rising levels of health care expenditure. According to Rolden, intervention programmes including information, support, therapy, and respite care for older people providing intensive care for their spouses could have financial merit besides any potential beneficial effects on well-being.
The research ‘Changes in health care expenditure after the loss of a spouse: Data on 6,487 older widows and widowers in the Netherlands’ by Herbert J.A. Rolden, David van Bodegom and Rudi G.J. Westendorp has been published in international, peer-reviewd publication PLOS ONE on Tuesday 23 December 2014: http://dx.plos.org/10.1371/journal.pone.0115478.