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A Projection Method for Public Health and Long-Term Care Expenditures


  • Christine de la Maisonneuve


  • Joaquim Oliveira Martins



This paper proposes a new set of public health and long-term care expenditure projections until 2060, seven years after a first set of projections was published by the OECD. It disentangles health from longterm care expenditure, as well as the demographic from the non-demographic drivers, and refines the previous methodology, in particular by extending the country coverage. Regarding health care, nondemographic drivers are identified, with an attempt to better understand the residual expenditure growth by determining which share can be explained by the evolution of health prices and technology effects. Concerning LTC, an estimation of the determinants of the number of dependants (people needing help in their daily life activities) is provided. A cost-containment and a cost-pressure scenario are provided, together with sensitivity analysis. On average across OECD countries, total health and long-term care expenditure is projected to increase by 3.3 and 7.7 percentage points of GDP between 2010 and 2060 in the cost-containment and the cost-pressure scenarios respectively. For the BRIICS over the same period, it is projected to increase by 2.8 and 7.3 percentage points of GDP in the cost-containment and the costpressure scenarios respectively. Une méthode de prévisions des dépenses publiques de santé et de soins de longue durée Ce papier présente une nouvelle série de projections des dépenses publiques de santé et de soins de longue durée jusqu’en 2060, sept ans après la publication d’une première série de projections par l’OCDE. Le papier étudie la santé et les soins de longue durée séparément ainsi que les déterminants démographiques et non-démographiques et il affine la méthodologie adoptée précédemment, en particulier, en augmentant le nombre de pays couverts. En ce qui concerne la santé, les déterminants non-démographiques sont identifiés, l’analyse effectuée dans ce papier tentant de mieux comprendre la croissance résiduelle des dépenses en déterminant quelle part peut être attribuée à l’évolution des prix de la santé et de la technologie. En ce qui concerne les soins de longue durée, une estimation des déterminants du nombre de dépendants (personnes nécessitant de l’aide dans les activités de la vie quotidienne) est utilisée. Un scénario de maîtrise des coûts et un scénario de tension sur les coûts sont élaborés ainsi qu’une analyse de sensibilité. En moyenne sur l’ensemble des pays de l’OCDE, entre 2010 et 2060, le total des dépenses de santé et de soins de longue durée devrait augmenter de 3.3 points de pourcentage de PIB dans le scénario de maîtrise des coûts et de 7.7 points de pourcentage de PIB dans le scénario de tension sur les coûts. Pour les BRIICS sur la même période, il devrait augmenter de 2.8 points de pourcentage du PIB dans le scenario de maîtrise des coûts et de 7.3 points de pourcentage dans le scenario de tension sur les coûts.

Suggested Citation

  • Christine de la Maisonneuve & Joaquim Oliveira Martins, 2013. "A Projection Method for Public Health and Long-Term Care Expenditures," OECD Economics Department Working Papers 1048, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:1048-en
    DOI: 10.1787/5k44v53w5w47-en

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    Cited by:

    1. Debra Bloch & Falilou Fall, 2016. "Government Debt Indicators:Understanding the Data," Journal of International Commerce, Economics and Policy (JICEP), World Scientific Publishing Co. Pte. Ltd., vol. 7(01), pages 1-28, February.
    2. Sergey Sinelnikov-Murylev & Eugene Goryunov & Laurence Kotlikoff, 2015. "Theoretical foundations of fiscal gap as a long-term fiscal sustainability indicator and its estimates for Russia," Research Paper Series, Gaidar Institute for Economic Policy, issue 168P, pages 1-58.
    3. Jukka Lassila & Tarmo Valkonen, 2014. "Health and Long-Term Care Expenditure in Finland When Living Alone Increases," Nordic Journal of Political Economy, Nordic Journal of Political Economy, vol. 39, pages 1-1.
    4. Alessandro Bucciol & Laura Cavalli & Igor Fedotenkov & Paolo Pertile & Veronica Polin & Nicola Sartor & Alessandro Sommacal, 2015. "Public policies over the life cycle: a large scale OLG model for France, Italy and Sweden," Working Papers 29/2015, University of Verona, Department of Economics.
    5. Fan, Victoria Y. & Savedoff, William D., 2014. "The health financing transition: A conceptual framework and empirical evidence," Social Science & Medicine, Elsevier, vol. 105(C), pages 112-121.

    More about this item


    ageing populations; demographic and non-demographic effects; dépenses publiques de santé; dépenses publiques de soins à long terme; effets démographiques et non démographiques; long-term care expenditures; longevity; longévité; méthodes de projection; projection methods; public health expenditures; vieillissement de la population;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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