title: Public healthcare expenditure in Spain: measuring the impact of driving factors.
abstract: OBJECTIVE
  To assess the impact of demography, health status, death related costs and some macroeconomic variables on the evolution of health expenditure.
  
  
  METHODS
  We follow the methodology used by the Ageing Working Group (AWG) of the European Union to simulate expenditure projections on the basis of healthcare expenditure profiles for age-sex population groups. We estimate the profiles using data from Hospital Discharges Statistics and the Spanish National Health Survey.
  
  
  RESULTS
  The differences between the compression of morbidity scenario and the expansion of morbidity scenario range from 1.35 to 1.57 points of GDP in 2060. The overestimation of healthcare expenditure when death related costs are ignored ranges from 0.04 to 0.11 percentage points, depending on the health status hypothesis. Moreover, the effect of death related cost diminishes as health status improves.
  
  
  CONCLUSIONS
  Our results support the fact that intensity of healthcare use, instead of ageing, is the main driver of health expenditure. Thus, the concern of keeping expenditure under control should be focused on factors such as the population's health status, economic growth and development, new technologies and medical progress, and the organization and management of the healthcare system.
authors.affiliation: Spanish Ministry of Finance and Public Administration and Complutense University of Madrid, Spain.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Blanco-Moreno
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Urbanos-Garrido
authors.forename: Israel John
authors.initials: IJ
authors.lastname: Thuissard-Vasallo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006304:Health Status; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013030:Spain; D055815:Young Adult