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BMC Public Health

, 15:1024

First Online: 06 October 2015Received: 06 January 2015Accepted: 28 September 2015DOI: 10.1186-s12889-015-2357-2

Cite this article as: Peters, F., Nusselder, W.J., Reibling, N. et al. BMC Public Health 2015 15: 1024. doi:10.1186-s12889-015-2357-2


BackgroundSince 2001 the Netherlands has shown a sharp upturn in life expectancy LE after a longer period of slower improvement. This study assessed whether changes in healthcare expenditure HCE explain this reversal in trends in LE. As an alternative explanation, the impact of changes in smoking behavior was also evaluated.

MethodsTo quantify the contribution of changes in HCE to changes in LE, we estimated a health-production function using a dynamic panel regression approach with data on 19 OECD countries 1980–2009, accounting for temporal and spatial correlation. Smoking-attributable mortality was estimated using the indirect Peto-Lopez method.

ResultsAs compared to 1990–1999, during 2000–2009 LE in the Netherlands increased by 1.8 years in females and by 1.5 years in males. Whereas changes in the impact of smoking between the two periods made almost no contribution to the acceleration of the increase in LE, changes in the trend of HCE added 0.9 years to the LE increase between 2000 and 2009. The exceptional reversal in the trend of LE and HCE was not found among the other OECD countries.

ConclusionThis study suggests that changes in Dutch HCE, and not in smoking, made an important contribution to the reversal of the trend in LE; these findings support the view that investments in healthcare are increasingly important for further progress in life expectancy.

KeywordsHealthcare systems Life expectancy Smoking AbbreviationsLELife expectancy

HCEHealthcare expenditures

OECDOrganization for economic cooperation and development

GDPGross-domestic product

WHOWorld Health Organization

CIConfidence intervals

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-015-2357-2 contains supplementary material, which is available to authorized users.

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Autor: Frederik Peters - Wilma J. Nusselder - Nadine Reibling - Christian Wegner-Siegmundt - Johan P. Mackenbach

Fuente: https://link.springer.com/

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