Cohort effects on the need for health care and implications for health care planning in Canada
Section snippets
Background
Historically, planning for future health care expenditures and health human resources has rested on applying current levels of workforce supply and/or service use to expected changes in the size and demographic profile of the population, with little attention given to the needs for health care within populations and the changes in those needs over time (see for example, Nova Scotia Health Research Foundation [1] and MacKenzie et al. [2]) even though the objectives of publicly funded health care
Data
We use data from the Canadian Community Health Survey (CCHS) for 2001, 2003, 2005, 2007, 2010 and 2012. The CCHS is a cross-sectional survey, whose survey samples were constructed to provide reliable cross-sectional data on the health of the Canadian population, and include data on family physician and hospital utilisation as well as self-reported measures of health problems such as chronic and acute conditions. We weigh all analyses using the CCHS sampling weights which aim to ensure the
Results
The full sample contains 652,850 person–year observations. Excluding those aged less than 12 and those aged 80+ (since no upper cohort limit can be inferred from this open ended age group), and those with no information for the health measures results in a study sample of 612,115 person–years with 16 cohorts (1920–1924 to 1995–1999). Sample sizes for each age group over each survey year are presented in Supplementary Table S1.
Table 1 contains average rates of low SAH by age group and cohort.
Discussion
We set out to analyse the differences in health among different cohorts in the Canadian population and identify the implications for health care planning. We found that the effects of demographic change on the need for health care over time (as proxied by various specifications of low self-assessed health), are lower once we allow for cohort effects. In other words, applying current age-specific levels of health care use to future demographic changes in the population overestimates health care
Conflict of interest
The authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
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