The relationship between health care expenditures and time to death: focus on myocardial infarction patients

This study focuses on the relationship between health care expenditures (HCE) and time to death (TTD). This is a central theme of regional and national healthcare systems, given the current ageing of the population and the increasing expenditures. This study is aimed to investigate in-depth the causal-effect relationship between TTD and HCE. Existing regional health administrative archives have been used to build a cohort of patients with new-onset myocardial infarctions observed between 2003 and 2007. All patients are residents in the Italian region Friuli Venezia Giulia. Data on individual HCEs, socio-demographic and health status characteristics are included in the analysis, together with TTD. The econometric analysis is based on a sample selection approach necessary to account for the inflation patterns in the distributions of HCE and TTD. The main results suggest that the causal effect of TTD on HCEs (“red herring” hypothesis) is confirmed, while the reversal relationship is only partially revealed in the selection equation.