IDEAS home Printed from
   My bibliography  Save this article

Standardized Mortality Ratios and Canadian Health-Care Funding


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


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.

Suggested Citation

  • Kelly Bedard & John Dorland & Allan W. Gregory & Mark Rosenberg, 1999. "Standardized Mortality Ratios and Canadian Health-Care Funding," Canadian Public Policy, University of Toronto Press, vol. 25(1), pages 47-64, March.
  • Handle: RePEc:cpp:issued:v:25:y:1999:i:1:p:47-64

    Download full text from publisher

    File URL:
    Download Restriction: only available to JSTOR subscribers

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. 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.
    2. Kelly Bedard & John Dorland & Allan W. Gregory & Joanne Roberts, 2000. "Needs-based health care funding: implications for resource distribution in Ontario," Canadian Journal of Economics, Canadian Economics Association, vol. 33(4), pages 981-1008, November.
    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. 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.
    Full references (including those not matched with items on IDEAS)

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cpp:issued:v:25:y:1999:i:1:p:47-64. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Prof. Werner Antweiler). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.