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Title page
Contents
OECD Health Working papers 3
Acknowledgements 4
Executive Summary 5
Resume 7
1. Introduction 12
2. Age and health spending: a selected review of national and international studies 14
3. Data sources and methods used to adjust health spending for age 19
3.1. Applying a basic adjustment methodology 20
3.2. Using indirect and direct standardisation approaches 21
3.3. Current availability of health expenditure data disaggregated by age 25
4. Results of age-adjusting health spending 29
4.1. Basic adjustment of health expenditures 29
4.2. Indirect standardisation of health expenditures 30
4.3. Direct standardisation of health expenditures 33
5. Conclusion 36
Bibliography 38
Annex A. Data Sources 41
Annex B. OECD standard population and population pyramids for selected countries 43
Annex C. Per capita spending by age group, 2018 46
OECD Health Working Papers 47
Recent related OECD publications 48
Table 2.1. Health expenditures by provinces and territories in Canada, 2011 18
Table 3.1. Observed health spending in country A and B 22
Table 3.2. Indirect standardisation 22
Table 3.3. Observed health spending in country A and B 24
Table 3.4. External standard population 24
Table 3.5. Direct standardisation of health spending using an external standard population 24
Table 3.6. Advantages and disadvantages of direct and indirect standardisation 25
Table 4.1. Indirect age-standardised ratios of observed to expected health spending 32
Figure 2.1. Per Capita Healthcare Spending by Age Groups in 8 High-Income Countries in 2015 15
Figure 3.1. Share of the population older than 65 years in 2018(원문불량) 21
Figure 3.2. Age-spending profiles for selected OECD countries (variable year) 27
Figure 4.1. Per capita healthcare expenditures, 2018 - unadjusted 29
Figure 4.2. Per capita healthcare expenditures, 2018 - adjusted using share of population 65+ 30
Figure 4.3. 'OECD' age-spending profile to apply indirect standardisation 31
Figure 4.4. Per capita healthcare expenditures, 2018 - indirect standardisation 33
Figure 4.5. Per capita healthcare expenditures, 2018 - direct standardisation 34
Figure 4.6. Per capita health spending in the Netherlands, 2003 to 2017 35
Boxes
Box 3.1. Three approaches for adjusting health spending according to population age structure 20
Box 3.2. Hypothetical example of indirect standardisation of health spending 22
Box 3.3. Standard populations in OECD Health Statistics 23
Box 3.4. Hypothetical example for the direct standardisation of health spending 24
Box 3.5. Health Expenditures by Diseases and Conditions (HEDIC) survey 26
Box 4.1. Direct standardisation of health expenditure over time 35
Annex Tables
Table A.A.1. Data Sources and coverage by country 41
Table A.B.1. OECD standard population, 2015 43
Table A.C.1. Per capita spending by age group in USD 2018 PPP 46
Annex Figures
Figure A.B.1. Population pyramids for Israel and selected OECD countries, 2018 44
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