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A method for calculating the implied no-recovery three-state transition matrix using observable population mortality incidence and disability prevalence rates among the elderly

Author

Listed:
  • William Lim

    (Actuarial Studies and Statistics, Australian National University)

  • Gaurav Khemka

    (Actuarial Studies and Statistics, Australian National University)

  • David Pitt

    (Macquarie University)

  • Bridget Browne

    (Actuarial Studies and Statistics, Australian National University)

Abstract

The most accurate estimation of transition probabilities for a multi-state model of health status requires longitudinal data. However, for many countries such data are usually not available. Instead, population level mortality incidence and disability prevalence rates are often all that can be accessed. In this paper, for a three-state no-recovery model (with states healthy, disabled, dead), using simple mathematical derivations, we propose a framework to estimate the age- and gender-specific boundaries within which each of the transition probabilities should fall. We then provide two methods for estimating unique transition probabilities—a least squares procedure and a method based on the ‘extra mortality’ factor proposed by Rickayzen and Walsh (Br Actuarial J 8(2):341–393, 2002, https://doi.org/10.1017/s1357321700003755 ). We also show the acceptable range for the ‘extra mortality’ factor given the mortality and disability data. Furthermore, we provide a critique of the method proposed by Van der Gaag et al. (Demogr Res 32:75, 2015), as their estimates can fall outside the acceptable boundaries. Finally, we estimate life and health expectancies, as well as premium rates for a life care annuity and a disability annuity using our derived transition probabilities.

Suggested Citation

  • William Lim & Gaurav Khemka & David Pitt & Bridget Browne, 2019. "A method for calculating the implied no-recovery three-state transition matrix using observable population mortality incidence and disability prevalence rates among the elderly," Journal of Population Research, Springer, vol. 36(3), pages 245-282, September.
  • Handle: RePEc:spr:joprea:v:36:y:2019:i:3:d:10.1007_s12546-019-09226-9
    DOI: 10.1007/s12546-019-09226-9
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    1. Zhou-Richter, Tian & Gründl, Helmut, 2011. "Life care annuities: Trick or treat for insurance companies?," ICIR Working Paper Series 04/11, Goethe University Frankfurt, International Center for Insurance Regulation (ICIR).
    2. Moffitt, Robert, 1993. "Identification and estimation of dynamic models with a time series of repeated cross-sections," Journal of Econometrics, Elsevier, vol. 59(1-2), pages 99-123, September.
    3. Panos Kanavos & Olivier Wouters & Joan Costa-Font & Christophe Courbage & Peter Zweifel, 2017. "Policy Dilemmas in Financing Long-term Care in Europe," Global Policy, London School of Economics and Political Science, vol. 8(s2), pages 38-45, March.
    4. Mullen, Katharine M. & Ardia, David & Gil, David L. & Windover, Donald & Cline, James, 2011. "DEoptim: An R Package for Global Optimization by Differential Evolution," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 40(i06).
    5. Pla-Porcel, Javier & Ventura-Marco, Manuel & Vidal-Meliá, Carlos, 2016. "Life Care Annuities (Lca) Embedded In A Notional Defined Contribution (Ndc) Framework," ASTIN Bulletin, Cambridge University Press, vol. 46(2), pages 331-363, May.
    6. repec:bla:glopol:v:8:y:2017:i::p:38-45 is not listed on IDEAS
    7. Nicole L. Van Der Gaag & Govert Bijwaard & Joop de Beer & Luc Bonneux, 2015. "A multistate model to project elderly disability in case of limited data," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 32(3), pages 75-106.
    8. Shuji Tanaka, 2016. "A Proposal for Redesigning Social Security: Long-Term Care Pension," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 41(1), pages 98-117, January.
    9. Bartosz Przywara, 2010. "Projecting future health care expenditure at European level: drivers, methodology and main results," European Economy - Economic Papers 2008 - 2015 417, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    10. Anastasia Kostaki & Vagelis Panousis, 2001. "Expanding an abridged life table," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 5(1), pages 1-22.
    11. Richard G. Frank, 2012. "Long-term Care Financing in the United States: Sources and Institutions," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 333-345.
    12. Ehsan Khoman & James Mitchell & Martin Weale, 2008. "Incidence‐based estimates of life expectancy of the healthy for the UK: coherence between transition probabilities and aggregate life‐tables," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(1), pages 203-222, January.
    13. Joelle H. Fong & Adam W. Shao & Michael Sherris, 2015. "Multistate Actuarial Models of Functional Disability," North American Actuarial Journal, Taylor & Francis Journals, vol. 19(1), pages 41-59, January.
    14. B. A. Davis, 2002. "Estimating and interpolating a Markov chain from aggregate data," Biometrika, Biometrika Trust, vol. 89(1), pages 95-110, March.
    15. Pelzer, Ben & Eisinga, Rob & Franses, Philip Hans, 2002. "Inferring Transition Probabilities from Repeated Cross Sections," Political Analysis, Cambridge University Press, vol. 10(2), pages 113-133, April.
    16. Leora Friedberg & Wenliang Hao & Wei Sun & Anthony Webb & Zhenyu Li, 2014. "New Evidence on the Risk of Requiring Long-Term Care," Working Papers, Center for Retirement Research at Boston College wp2014-12, Center for Retirement Research.
    17. Ermanno Pitacco, 2016. "Premiums for Long-Term Care Insurance Packages: Sensitivity with Respect to Biometric Assumptions," Risks, MDPI, vol. 4(1), pages 1-22, February.
    18. Smith, Jacqui, 2001. "Well-being and health from age 70 to 100: findings from the Berlin Aging Study," European Review, Cambridge University Press, vol. 9(4), pages 461-477, October.
    19. Haberman, S., 1982. "The relationship between incidence and prevalence," Social Science & Medicine, Elsevier, vol. 16(8), pages 857-862, January.
    20. Irene Albarrán-Lozano & Pablo J. Alonso-González & Ana Arribas-Gil, 2017. "Dependence evolution in the Spanish disabled population: a functional data analysis approach," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 180(2), pages 657-677, February.
    21. Helms, Florian & Czado, Claudia & Gschlößl, Susanne, 2005. "Calculation of LTC Premiums Based on Direct Estimates of Transition Probabilities," ASTIN Bulletin, Cambridge University Press, vol. 35(2), pages 455-469, November.
    22. Francesca Colombo & Jérôme Mercier, 2012. "Help Wanted? Fair and Sustainable Financing of Long-term Care Services," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 316-332.
    23. Peter C. Smith & Nigel Rice & Roy Carr‐Hill, 2001. "Capitation funding in the public sector," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 164(2), pages 217-257.
    24. Hariyanto, Evan A. & Dickson, David C.M. & Pitt, David G.W., 2014. "Estimation of Disability Transition Probabilities in Australia I: Preliminary," Annals of Actuarial Science, Cambridge University Press, vol. 8(1), pages 131-155, March.
    25. Christine de la Maisonneuve & Joaquim Oliveira Martins, 2013. "Public Spending on Health and Long-term Care: A new set of projections," OECD Economic Policy Papers 6, OECD Publishing.
    26. Jason Brown & Mark Warshawsky, 2013. "The Life Care Annuity: A New Empirical Examination of an Insurance Innovation That Addresses Problems in the Markets for Life Annuities and Long-Term Care Insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 80(3), pages 677-704, September.
    27. Scott Lynch & J. Brown, 2010. "Obtaining multistate life table distributions for highly refined subpopulations from cross-sectional data: A bayesian extension of sullivan’s method," Demography, Springer;Population Association of America (PAA), vol. 47(4), pages 1053-1077, November.
    28. D. J. Pritchard, 2006. "Modeling Disability in Long-Term Care Insurance," North American Actuarial Journal, Taylor & Francis Journals, vol. 10(4), pages 48-75.
    29. Levantesi, Susanna & Menzietti, Massimiliano, 2012. "Managing longevity and disability risks in life annuities with long term care," Insurance: Mathematics and Economics, Elsevier, vol. 50(3), pages 391-401.
    30. Hariyanto, Evan A. & Dickson, David C. M. & Pitt, David G. W., 2014. "Estimation of Disability Transition Probabilities in Australia II: Implementation," Annals of Actuarial Science, Cambridge University Press, vol. 8(1), pages 156-175, March.
    31. Peng Shi & Wei Zhang, 2013. "Managed Care and Health Care Utilization: Specification of Bivariate Models Using Copulas," North American Actuarial Journal, Taylor & Francis Journals, vol. 17(4), pages 306-324.
    32. Eileen M. Crimmins & Hiram Beltrán-Sánchez, 2010. "Mortality and Morbidity Trends: Is There Compression of Morbidity?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 66(1), pages 75-86.
    33. Francesca Colombo & Jérome Mercier, 2012. "Help Wanted? Fair and Sustainable Financing of Long-term Care Services," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 316-332.
    34. Rickayzen, B.D. & Walsh, D.E.P., 2002. "A Multi-State Model of Disability for the United Kingdom: Implications for Future Need for Long-Term Care for the Elderly," British Actuarial Journal, Cambridge University Press, vol. 8(2), pages 341-393, June.
    35. Imai, Kosuke & Soneji, Samir, 2007. "On the Estimation of Disability-Free Life Expectancy: Sullivan's Method and Its Extension," Journal of the American Statistical Association, American Statistical Association, vol. 102, pages 1199-1211, December.
    36. Richard G. Frank, 2012. "Long-term Care Financing in the United States: Sources and Institutions," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 333-345.
    37. Ben Pelzer & Rob Eisinga, 2002. "Bayesian estimation of transition probabilities from repeated cross sections," Statistica Neerlandica, Netherlands Society for Statistics and Operations Research, vol. 56(1), pages 23-33, February.
    38. Agnes Lievre & Nicolas Brouard & Christopher Heathcote, 2003. "The Estimation Of Health Expectancies From Cross-Longitudinal Surveys," Mathematical Population Studies, Taylor & Francis Journals, vol. 10(4), pages 211-248.
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