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Standardized Mortality Ratios and Canadian Health-Care Funding

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  • Kelly Bedard
  • John Dorland
  • Allan W. Gregory
  • Mark Rosenberg

Abstract

Needs-based capitation models have been suggested as an alternative to health-care funding methods based on historical utilization patterns. The standardized mortality ratio (SMR) applied in conjunction with an age/gender adjustment is the most widely adopted measure of relative need. This paper addresses a number of important index construction issues using Canadian data and discusses their health policy implications. These include the influence exerted by the age structure (excluding people over 64 versus 74), the optimal period over which to average the SMR in order to smooth meaningless fluctuations, and the correspondence between SMRs, standard socioeconomic indicators (i.e., unemployment, education, and income) health-care "need," and expenditures.

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Bibliographic Info

Article provided by University of Toronto Press in its journal Canadian Public Policy.

Volume (Year): 25 (1999)
Issue (Month): 1 (March)
Pages: 47-64

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Handle: RePEc:cpp:issued:v:25:y:1999:i:1:p:47-64

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  1. Kelly Bedard & John Dorland & Allan W. Gregory & Joanne Roberts, 1999. "Needs-Based Health Care Funding: Implications for Resource Distribution in Ontario," Working Papers jorob-99-03, University of Toronto, Department of Economics.
  2. Stephen Birch & John Eyles & Bruce Newbold, 1995. "The Inevitability of Mortality? Evaluating Alternatives to the SMR," Centre for Health Economics and Policy Analysis Working Paper Series 1995-10, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
  3. Hay, David Ian, 1988. "Socioeconomic status and health status: A study of males in the Canada health survey," Social Science & Medicine, Elsevier, vol. 27(12), pages 1317-1325, January.
  4. M Barer & G Stoddart, 1991. "Toward Integrated Medical Resource Policies for Canada. 1. Background, Process and Perceived Problems," Centre for Health Economics and Policy Analysis Working Paper Series 1991-07A, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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