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Demographic Change and the Cost of Publicly Funded Health Care

Published online by Cambridge University Press:  29 November 2010

Frank T. Denton  and
Byron G. Spencer
Frank T. Denton
Affiliation:
McMaster University
Byron G. Spencer
Affiliation:
McMaster University
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Abstract

This paper is concerned with questions relating to demographic change (population growth and aging) and its implications for operating a publicly funded health care system in a Canadian setting. It provides an assessment of how prospective population changes alone would affect the share of health care costs in total national income in Canada over the next several decades; it provides also an analysis of how actual patterns of hospital service provision changed in Ontario over the last decade in response to budgetary restrictions in a period of rising demand for services. Finally, a case is made for viewing health care as an integrated system; a description is provided of a set of computer-based models that have been developed to facilitate analysis of the health care system, and illustrative projections are discussed.

Résumé

Cet article aborde les questions ayant trait aux changements démographiques (croissance démographique et vieillissement) et leurs répercussions sur le fonctionnement d'un système de soins de santé financé par le public dans le contexte canadien. L'étude évalue comment les changements démographiques peuvent avoir, à eux seuls, une incidence sur la répartition du coût des soins de santé dans le revenu national canadien au cours des prochaines décennies. Elle analyse également comment les tendances actuelles en matière de prestation de services hospitaliers ont changé au cours des dix dernières années, en Ontario, à la suite de compressions budgétaires; période pendant laquelle la demande en services était à la hausse. Finalement, les auteurs soutiennent que les soins de santé doivent être perçus comme un système intégré. Ils décrivent une série de modèles informatisés qui ont été élaborés afin de faciliter l'analyse du système de soins de santé, et discutent de pronostics explicatifs.

Keywords

Demographic ChangeHealth ServicesHealth Care CostsIntegrated System.Changements démographiquessoins médicauxcoûtperspective systémique.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 14 , Issue 2 , Été/Summer 1995 , pp. 174 - 192
Copyright
Copyright © Canadian Association on Gerontology 1995

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References

Barer, M.L., & Stoddart, G.L. (1991). Toward Integrated Medical Resource Policies for Canada. Prepared for the Federal/Provincial/Territorial Conference of Deputy Ministers.Google Scholar
Birch, S., & Chambers, S. (1993). To each according to need: a community-based approach to allocating health care resources. Canadian Medical Association Journal, 149(5).Google Scholar
Birch, S., Eyles, J., Hurley, J., Hutchison, B., & Chambers, S. (1993). A Needs-based Approach to Resource Allocation in Health Care. Canadian Public Policy — Analyse de Politiques, XIX(1), 68–85.CrossRefGoogle Scholar
Birch, S., Lavis, J., Markham, B., Woodward, C, & O'Brien-Pallas, L. (1994). Nursing Requirements for Ontario Over the Next Twenty Years: Development and Application of Estimation Methods. Unpublished report, McMaster University.Google Scholar
Blomqvist, Å., & Brown, D.M. (Eds.). (1994). Limits to Care: Reforming Canada's Health System in an Age of Restraint. Toronto: CD. Howe Institute, Policy Study 20.Google Scholar
Coyte, P.C. (1994). Providers' Perceptions, Geographic Variation, and the Cost-Effective Provision of Health Care Services. In Blomqvist & Brown (1994).Google Scholar
Denton, F.T., Feaver, C.H., & Spencer, B.G. (1992). MEDS Users' Manuals. Program for Quantitative Studies in Economics and Population, McMaster University.Google Scholar
Denton, F.T., Feaver, C.H., & Spencer, B.G. (1994). Economic-Demographic Projection and Simulation: A Description of the MEDS System of Models. In Rao, K.V. & Wicks, Jerry W. (Eds.), Studies in Applied Demography: Proceedings of the International Conference on Applied Demography. Bowling Green, OH: Bowling Green State University Press.Google Scholar
Denton, F.T., Gafni, A., & Spencer, B.G. (1992). Resource Requirements and Availability: An Integrated System of Models for Health Care Planning. In Chytil, M.K., Duru, G., Eimeren, W.V., & Flagle, C.D. (Eds.), Health Systems: The Challenge of Change. Prague: Omnipress.Google Scholar
Denton, F.T., Gafni, A., & Spencer, B.G. (1993). The SHARP Computer System: A Tool for Resource Planning in the Health Care Sector. In Malek, M., Rasquinha, J., & Vacani, P. (Eds.), Strategic Issues in Health Care Management. Toronto: John Wiley and Sons Ltd.Google Scholar
Denton, F.T., Gafni, A., & Spencer, B.G. (1994). System for Health Care Planning (SHARP): An Application to Ontario Medical School Enrolment. Canadian Medical Association Journal, 151(1).Google Scholar
Denton, F.T., Gafni, A., & Spencer, B.G. (forthcoming). The SHARP Way to Plan Health Care Services: A Description of the System and Some Illustrative Applications in Nursing Human Resource Planning, Socio-Economic Planning Sciences.Google Scholar
Denton, F.T., Gafni, A., Spencer, B.G., & Stoddart, G.L. (1983). Potential Savings from the Adoption of Nurse Practitioner Technology in the Canadian Health Care System. Socio-Economic Planning Sciences, 17(4).CrossRefGoogle ScholarPubMed
Denton, F.T., & Spencer, B.G. (1992). An Analysis of Resource Utilization in the Ontario Hospital System: 1980–1990. A report prepared for the Task Force on the Use and Provision of Medical Services.Google Scholar
Evans, J.R. (1973). Physicians in a Public Enterprise. Journal of Medical Education, 48, 975–986.Google Scholar
Evans, R.G. (1984). Strained Mercy: The Economics of Canadian Health Care. Toronto: Butterworth & Co. Ltd.Google Scholar
Evans, R.G. (1985). Illusions of Necessity: Evading Responsibility for Choice in Health Care. Journal of Health Politics, Policy and Law, 10(3), 439–467.CrossRefGoogle ScholarPubMed
Evans, R.G., Lomas, J., Barer, M.L., Labelle, R.J., Fooks, C., Stoddart, G.L., Anderson, G.M., Feeny, D., Gafni, A., Torrance, G.W., & Tholl, W.G. (1989). Controlling Health Expenditures — The Canadian Reality. New England Journal of Medicine, 320(9), 571–577.CrossRefGoogle ScholarPubMed
Evans, R.G., & Stoddart, G.L. (1990). Producing Health, Consuming Health Care. Social Science and Medicine, 31(12).CrossRefGoogle ScholarPubMed
Eyles, J., & Birch, S. (1993). A Population Needs-based Approach to Health-care Resource Allocation and Planning in Ontario: A Link Between Policy Goals and Practice? Canadian Journal of Public Health, 84(2).Google ScholarPubMed
Eyles, J., Birch, S., Chambers, S., Hurley, J., & Hutchison, B. (1991). A Need-based Methodology for Allocation Health Care Resources in Ontario, Canada: Development and an Application. Social Sciences and Medicine, 33(4).CrossRefGoogle Scholar
Feeny, D. (1994). Technology Assessment and Health Policy in Canada. In Blomqvist & Brown (1994).Google Scholar
Henripin, J. (1994). The Financial Consequences of Population Aging. Canadian Public Policy — Analyse de Politiques, XX(1), 78–94.CrossRefGoogle Scholar
Lomas, J., Barer, M.L., & Stoddart, G.L. (1985). Physician Manpower Planning: Lessons from the Macdonald Report, Ontario Economic Council. Discussion Paper Series.Google Scholar
Lomas, J., Stoddart, G.L., & Barer, M.L. (1985). Supply Projections as Planning: A Critical Review of Forecasting Net Physician Requirements in Canada. Social Science and Medicine, 20(4), 411–424.CrossRefGoogle ScholarPubMed
OECD. (1993a). Health Systems Facts and Trends 1960–1991, Vol. 1, Health Policy Studies No. 3.Google Scholar
OECD. (1993b). Health Data Program, 1993 Version. Paris: Centre de Recherches d'Études et de Documentation en Économie de la Santé.Google Scholar
Taylor, M.G. (1990). Insuring National Health Care: The Canadian Experience. Chapel Hill: University of North Carolina Press.Google Scholar
Tholl, W.G. (1994). Health Care Spending in Canada: Skating Faster on Thinner Ice. In Blomqvist & Brown (1994).Google Scholar