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Cohort effects on the need for health care and implications for health care planning in Canada

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  • Whittaker, William
  • Birch, Stephen
  • MacKenzie, Adrian
  • Murphy, Gail Tomblin

Abstract

The sustainability of publicly funded health care systems is an issue for governments around the world. The economic climate limits governments’ fiscal capacity to continue to devote an increasing share of public funds to health care. Meanwhile the demands for health care within populations continue to increase. Planning the future requirements for health care is typically based on applying current levels of health service use by age to demographic projections of the population. But changes in age-specific levels of health over time would undermine this ‘constant use by age’ assumption. We use representative Canadian survey data (Canadian Community Health Survey) covering the period 2001–2012, to identify the separate trends in demography (population ageing) and epidemiology (population health) on self-reported health. We propose an approach to estimating future health care requirements that incorporates cohort trends in health. Overall health care requirements for the population increase as the size and mean age of the population increase, but these effects are mitigated by cohort trends in health—we find the estimated need for health care is lower when models account for cohort effects in addition to age effects.

Suggested Citation

  • Whittaker, William & Birch, Stephen & MacKenzie, Adrian & Murphy, Gail Tomblin, 2016. "Cohort effects on the need for health care and implications for health care planning in Canada," Health Policy, Elsevier, vol. 120(1), pages 81-88.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:1:p:81-88
    DOI: 10.1016/j.healthpol.2015.10.007
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    References listed on IDEAS

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    1. Herbert L. Smith, 2008. "Advances in Age–Period–Cohort Analysis," Sociological Methods & Research, , vol. 36(3), pages 287-296, February.
    2. Tomblin Murphy, Gail & Kephart, George & Lethbridge, Lynn & O'Brien-Pallas, Linda & Birch, Stephen, 2009. "Planning for what? Challenging the assumptions of health human resources planning," Health Policy, Elsevier, vol. 92(2-3), pages 225-233, October.
    3. Linda G. Martin & Robert F. Schoeni & Vicki A. Freedman & Patricia Andreski, 2007. "Feeling Better? Trends in General Health Status," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 62(1), pages 11-21.
    4. Yang Yang & Kenneth C. Land, 2008. "Age–Period–Cohort Analysis of Repeated Cross-Section Surveys: Fixed or Random Effects?," Sociological Methods & Research, , vol. 36(3), pages 297-326, February.
    5. Wenjiang J. Fu, 2008. "A Smoothing Cohort Model in Age–Period–Cohort Analysis With Applications to Homicide Arrest Rates and Lung Cancer Mortality Rates," Sociological Methods & Research, , vol. 36(3), pages 327-361, February.
    6. Stephen Birch & George Kephart & Gail Tomblin-Murphy & Linda O'Brien-Pallas & Rob Alder & Adrian MacKenzie, 2007. "Human Resources Planning and the Production of Health: A Needs-Based Analytical Framework," Canadian Public Policy, University of Toronto Press, vol. 33(s1), pages 1-16, January.
    7. Christopher Winship & David J. Harding, 2008. "A Mechanism-Based Approach to the Identification of Age–Period–Cohort Models," Sociological Methods & Research, , vol. 36(3), pages 362-401, February.
    8. Robert M. O'Brien & Kenneth Hudson & Jean Stockard, 2008. "A Mixed Model Estimation of Age, Period, and Cohort Effects," Sociological Methods & Research, , vol. 36(3), pages 402-428, February.
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    Cited by:

    1. Lenzen, Sabrina & Birch, Stephen, 2023. "From population numbers to population needs: Incorporating epidemiological change into health service planning in Australia," Social Science & Medicine, Elsevier, vol. 328(C).

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