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Standardized Mortality Ratios and Canadian Health-Care Funding

Author

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

Abstract

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
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. G Stoddart & M Barer, 1991. "Toward Integrated Medical Resource Policies for Canada. 10. Information Creation and Dissemination," Centre for Health Economics and Policy Analysis Working Paper Series 1991-07J, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    4. 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.
    5. 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.
    6. Stephen Birch & John Eyles & Jeremiah Hurley & Brian Hutchison & Shelley Chambers, 1993. "A Needs-based Approach to Resource Allocation in Health Care," Canadian Public Policy, University of Toronto Press, vol. 19(1), pages 68-85, March.
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