[Impact of population ageing on medical consumption: compulsory health insurance in Morocco]. / L'impact du vieillissement démographique sur la consommation médicale: assurance maladie obligatoire au Maroc.

INTRODUCTION: compulsory health insurance schemes for all employees in public and private sector are causing, on the one hand, continual health care spending growth and, on the other hand, are experiencing an increase in the number of covered population aged over 60 years. The purpose of this study was to analyze the impact of ageing on the estimated average expenditure per covered person with health insurance. METHODS: we conducted Kruskal-Wallis test to assess whether there was any significant difference between populations of different age on medical consumption, depending on whether the person was affected or not by a diseases of long duration. Other indicators were also analyzed, namely the proportion of the population suffering from a disease of long duration demanding health care, the average expenditure per person affected by a diseases of long duration and the average expenditure per covered person not affected by a disease of long duration for both people under 60 years and those over 60 years. RESULTS: Kruskal-Wallis test showed that age is an explanatory variable for the average expenditure per covered person. The examination of the evolution of the main components of average expenditure allowed to highlight other factors. CONCLUSION: population ageing contributes to the increase of medical consumption but there are other factors which have a significant effect on the increase in expenditure.

[Literature review regarding the impact of population aging on healthcare expenditure growth: Organisation for Economic Co-operation and Development member countries and Morocco]. / Revue de la littérature sur l'impact du vieillissement démographique sur l'évolution des dépenses médicales: pays de l'Organisation de Coopération et de Développement Economiques et Maroc.

This study aims to offer an overview of literature published on the relationship between population aging and healthcare expenditure growth in countries where this phenomenon is already significant and in Morocco. The first 19 most cited articles published over the period 1995-2014 are concerned with Organisation for Economic Co-operation and Development member countries as well as with countries where the impact of aging on healthcare expenditures has been evaluated quantitatively. With regard to Morocco, our research focused on publications from national governments regarding medical consumption growth and its link with age. Reasearch studies on OECD member countries that include proximity of death in explanatory models for healthcare expenditures, conclude that this last can explain better than age healthcare expenditure growth. Four authors highlight that explanatory models for healthcare expenditures which do not take into consideration proximity of death overestimate projection results. Ten studies suggest that healthcare expenditure growth is attributable to factors other than population aging. With regard to Morocco, only a report on compulsory health insurance shows that there is a relationship between age and expenditures since the prevalence of chronic diseases that affect mostly older people entails significant expenditures for compulsory health insurance. Given the speed of the aging in Morocco, it is necessary to conduct studies in order to understand the dynamics of healthcare expenditures.