Dynamic microsimulation of health care demand, health care finance and the economic impact of health behaviours: Survey and review
- Statistics Canada, Canada
Cite this article
as: M. Spielauer; 2007; Dynamic microsimulation of health care demand, health care finance and the economic impact of health behaviours: Survey and review; International Journal of Microsimulation; 1(1); 35-53.
doi: 10.34196/ijm.00005
Tables
Table A.1
Summary model descriptions
| Model | Institution / Country | Description | Data | Time period | Population | Link |
|---|---|---|---|---|---|---|
| APPSIM | Australia – NATSEM | APPSIM (Australian Population and Policy Simulation Model) is the second generation dynamic simulation model built at NATSEM It aims at providing policymakers with the right toolbox to assess and prepare for the social and fiscal challenges ahead that are associated with the aging of the Australian population. (Cassells et al., 2006) The APPSIM improvements over previous models are the easy replacement of modules, the fully integrated alignment and aggregate calibration from the start for every module, the ability to change the order of simulation, the flexibility in output, and the clear focus on user needs and requirements. (Kelly, 2007a, b) | HILDA | discrete | closed | http://www.canberra.edu.au/centres/natsem |
| DYNAMOD | Australia – NATSEM | The DYNAMOD model, a dynamic microsimulation model of the Australian population, is designed to project characteristics of the population over a period of up to 50 years. (King et al., 1999) Major elements of the model include demographics, international migration, education, the labour market and earnings. DYNAMOD uses a “pseudo-continuous” time framework operating in monthly steps for most demographic and labour market processes and in annual steps for education and earnings. With regard to the statistical modelling approaches used, it makes maximum use of survival functions. | n = 150,000 sample of census | discrete (months) | closed | http://www.canberra.edu.au/centres/natsem |
| HealthMod | Australia – NATSEM | This is a model currently being developed that simulates the use and costs of medical and related services by Australian families. The objective is to be able to analyse distributional impacts of potential policy changes as well as the revenue and expenditure implications for government. The unit of analysis is the family. The data is based on the Australian Bureau of Statistics (ABS) 2001 National Health Survey (NHS01). This dataset needed to be enriched by statistical matching techniques in order to additionally be able to model at the family level rather than solely at the individual level. | 2001 National Health Survey | discrete | closed | http://www.canberra.edu.au/centres/natsem |
| FAMSIM+ | Austria | FAMSIM+ is a dynamic microsimulation modelling platform for Austria developed alongside a PhD thesis (Spielauer, 2003). It contains basic demographics like fertility and partner matching by education, as well as a more detailed educational module for the study of the intergenerational transmission of education in Austria. FAMSIM+ is an example of a simple and focused model. Technically it follows an object oriented programming approach. Its simplicity together with the programming approach made it also a teaching tool. | 1996 Micro Census special program on education and fertility | discrete (months) | closed | |
| DYNACAN | Canada – Canada Pension Plan | DYNACAN is a Canadian stochastic dynamic microsimulation model for fiscal and policy-oriented analysis of the Social Security System in Canada and mainly focusing on the Canada Pension Plan (CPP). The model is made up of three main components (Morrison 1998/ Dussault 2000): DYNACAN A assembles the initial representative data base from various data sources; DYNACAN B simulates the demographics and employment earnings over time. This module also includes the modelling of disability and recovering from disability; DYNACAN C calculates the CPP contributions and benefits. | n = 212,000 sample from 1971 Census | discrete | closed | |
| LifePaths | Canada – Statistics Canada | LifePaths is an integrated “general purpose” model, including demographic behaviours, health, education, labour and allowing for tax-benefit and pension modelling. It operates in continuous time which (amongst other things) allows for a more accurate representation of causation and behaviour. LifePaths uses a synthetic initial database based on a variety of historical micro-data sources in order to create representative synthetic life histories from birth to death for all birth cohorts since 1872. The model is programmed in the generic microsimulation language Modgen. | synthetic population (sample size set by user) | continuous | open | http://dissemination.statcan.ca/english/spsd/LifePaths.htm |
| POHEM | Canada – Statistics Canada | POHEM (Population Health Model) started as a sister model of LifePaths and over time developed to a family of different model variants for different health-related applications. POHEM is a dedicated health model. Typical output includes measures of cost effectiveness, cost per year of life gained, cost per health-adjusted year of life gained and measures on the impact of interventions on incidence and survival. In addition, disease-specific survival curves and costs of care for co-morbidities can be established. The model is programmed in the generic microsimulation language Modgen. | (1) synthetic population (sample size set by user) or (2) Canadian Community Health Survey |
continuous | open | http://dissemination.st atcan.ca/english/spsd/Pohem.htm |
| DESTINIE | France – INSEE | DESTINIE is an analytical tool for pension policy which produces pension projections to the year 2040. The demographic transition probabilities are based on the “school living age”, which is a major covariate of the model, but the labour market transition probabilities are based on age, gender and education levels. Wage trajectories of individuals from the same cohort, gender and educational attainment are represented using autoregressive random components to account for additional dispersion (Blanchet & Crenner 2006). | n = 50,000 Financial Assets Survey 1991, 1997, 2003 | discrete | closed | http://www.insee.fr |
| ANAC, DYNAMITE | Italy – Bank of Italy | The ANAC-model was developed at the University of Pennsylvania by Alberto Ando and Sergei Nicoletti Altimari to examine the Italian savings behaviour. DYNAMITE was developed by the Bank of Italy (Banca d’Italia) based on ANAC. The aim of this model is to examine microeconomic questions at the household level and the impact of macroeconomic factors and institutional changes on distributional issues. The program contains three special modules. A labour market model that utilizes insight from search theory, a tax calculation module, and a retirement decision module that determines the retirement decision endogenously. |
n = 24,000 1993 Survey on Household Income and Wealth | discrete | closed | |
| MIND | Italy – University of Pisa | MIND (Micro Italy National Dynamics) simulates the demography and the socio-economic structure of Italy, by taking into account the three different macro-regions North, Centre and South. Model development started in 1998 at the University of Pisa. The current version of the model has been used to evaluate the long term effects of the Italian national pension system and the short term effects of the Italian personal tax system. Economic equality is not studied cross-sectional only by estimating the distribution of disposable income in a given year, but also for prolonged periods to cover several years, or the entire lifetime of different generations. | 1995 starting population constructed from various surveys | discrete | closed | http://www.unipr.it/arpa/defi/microsim/home.html |
| MIDAS | New Zealand | The Microsimulation of Income Dynamics and Accumulation of Savings (MIDAS) was created to examine wealth accumulation and distribution in New Zealand. The project was commissioned by the Department of the Prime Minister and Cabinet on behalf of the Task Force on Private Provision for Retirement. Accordingly, its focus was on estimating the proportion of people who could provide for their own retirement by the age of 65. | n = 10,000; sample from census 1991 | discrete | closed | http://www.retirement.org.nz/midas_model.html |
| MOSART | Norway – Statistics Norway | MOSART is a dynamic microsimulation model for Norway developed at Statistics Norway to investigate policy options with regard to financing public expenditure. In its first version developed between 1988 and 1990 it focused on demographic behaviour, education and labour force participation in order to study the impact of demographic change on labour force and education attainment (Fredriksen 1998). The second version (1991–93) extends the model, allowing for pension modeling. Currently MOSART exists in its third version (since 1996) that includes more detailed modules with respect to household formation, income, taxation, savings, wealth (Fredriksen 2003) and disability. | Register data representing 12% of the population | discrete | closed | http://www.ssb.no/emner/02/03/sos101 |
| MicroPox | Sweden – individual PhD thesis by Brouwers (2005) | The probabilistic dynamic microsimulation model MicroPox is based on the SVERIGE model. It is spatially explicit on 100x100m square grid. The data set for the model is extracted from anonymized administrative registers of the whole Swedish population from 1998 which includes information on family relations and workplaces containing location. The model is run with hourly changes. Places and persons are the fundamental entries. The distinguishing features from other epidemiological models are the inclusion of contact patterns and detailed spatial information. The purpose of this transmission model is to analyze and compare different intervention possibilities to prevent a spread of the infectious disease smallpox (Brouwers 2005). | 1998 register data of the Swedish population | discrete (hours) | closed | |
| SESIM | Sweden – Ministry of Finance | SESIM is a dynamic and stochastic microsimulation model developed by the Swedish Ministry of Finance. The first version was developed in 1997 as a tool to assess the Swedish education financing system (Ericson and Hussénius, 2000). The second version (Flood 2004) has been developed since the year 2000 to “evaluate the financial sustainability of the new Swedish pension system”. SESIM III is the current version: the major purpose is still pensions, but “the new version extends the analyses of health issues amongst elderly” (Flood et al., 2005). | n = 100,000 1999 year wave of LINDA. | discrete | closed | http://www.sesim.org |
| SVERIGE, LISA, SVESIM | Sweden – SMC | SVERIGE is the first of a family of models developed by the Spatial Modelling Centre in Kiruna (Sweden) and is based on the CORSIM model extended by a spatial dimension locating individuals on a 100m2 grid. Different to most other models, it is not based on a sample but simulates the entire Swedish population based on detailed longitudinal administrative data. It is mainly used to evaluate human ecodynamics (Holm et al., 2002). While health issues are not modelled in SVERIGE, the model is the basis for the development of an epidemiological model MicroPox (Brouwers, 2005). LISA is a later simplified version of the original model with updated equations and an incorporation of individual income sources targeting labour supply issues. It only looks at individuals, not at families, and locates migrants on a larger scale of labour market regions (Holm et al., 2006). The most recent development is the model SVESIM which has the detail of the original model and further includes labour demand and individual labour market clearing (Holm et al., 2006). |
n = 9,000,000 administrative data 1985–95 | discrete | closed | http://www3.umu.se/soc_econ_geography/smc/ |
| MICROHUS | Sweden – Uppsala University | MICROHUS is a dynamic micro simulation model for the Swedish household sector including tax and transfer system and people’s behavioural “adjustments to policy changes” (Klevmarken, 2001: 20). The simulation model contains the following model “blocks”: demographics, geographical mobility, housing, labour market, wealth, income and taxes, childcare, price levels. MICROHUS has been used in an evaluation of the 1990/91 tax reform in Sweden (Klevmarken & Olovsson, 1996). Furthermore the impact of demographic changes on the income distribution has been studied with this microsimulation model (Klevmarken, 1994). | Swedish household sample HUS 1984 | continuous | closed | |
| SAGEMOD | UK – London School of Economics, King’s College, University of Southampton | The Simulating Social Policy in an Ageing Society (SAGE) project, funded by the Economic and Social Research Council (ESRC) started in 1999. Its main goal is the assessment of ageing population’s impact on future pension, health and long-term care policies. Along with the series of static simulation models for policies’ impact evaluation, SAGE has developed a dynamic microsimulation model (SAGEMOD) for projecting the British population until 2031. Incorporating census, panel and cross-sectional survey data, it simulates the following events: birth, death, education, marriage, divorce, labour force participation, earnings, health, retirement, disability and informal care. | n = 54,000 0.1% of 1991 Census | discrete | closed | http://www.lse.ac.uk/collections/SAGE/research/modellingForPolicy/SAGEMOD/Default.htm |
| NCCSU | UK – University of Leicester; London School of Economics | The NCCSU Micro-simulation Model for Long-Term Care Charging simulates the incomes and assets of future cohorts of older people and their ability to contribute towards care costs. It was developed Nuffield Community Care Studies Unit (NCCSU) at the University of Leicester and serves as the microsimulation component in a long-term-care micro-macro model. The macro component is the PSSRU Long-Term Care Financing Model that aims to make projections of three key variables: the expected number of older people (aged 65 and over) with dependency, their likely level of demand for long-term care services and the costs associated with meeting this demand. | British Family Resources Survey (FRS) | discrete | closed | http://www2.le.ac.uk/departments/health-sciences http://www.pssru.ac.uk |
| CBOLT | US – Congressional Budget Office | The Congressional Budget Office Long-Term (CBOLT) policy simulation model is an integrated micro/macro policy simulation model. It was developed to answer budgetary and distributional questions about Social Security, Medicare, and other long-term policy issues. The model uses dynamic microsimulation within an aggregate budgetary and macroeconomic framework to generate long-run projections and policy analysis for aging-related programs like Social Security and Medicare. CBOLT is used to analyze how sensitive theses programs are to demographic, economic, and behavioural assumptions. The model is designed to examine the effects of various federal budget policy options, such as alternative Social Security tax and benefit rules, Medicare eligibility and cost growth assumptions but also to simulate the effects of various fundamental policy changes such as private accounts, trust fund investment. | Continuous Wage History Survey (SSA) and Center for Medicare and Medicaid Studies (CMS) | discrete | closed | http://www.cbolt.com |
| CORSIM | US – Cornell University; Strategic Forecasting | The Cornell Dynamic Population Microsimulation Model (CORSIM) started its development at Cornell University (U.S) in 1987. The fourth and most recent version of it was released in September 2002. This model has been built for research into fundamental socioeconomic process and policy analysis. CORSIM included information on both the individual and family levels and has been applied to investigate changes occurring in family networks, wealth accumulation, patterns of intergenerational mobility, and to assess policy reforms of several US administrations. CORSIM has served as template for other models, e.g. DYNACAN built in 1995 (CANADA) and SVERIGE in 1997 (SWEDEN). | n = 180,000 US Census Public Use Micro data Sample (PUMS) | discrete | closed | http://www.strategicforecasting.com/ |
| PENSIM/2 | US – Department of Labour | PENSIM/2 is geared toward the analysis of employer-sponsored pension plans (Holmer et al., 2007) It is a dynamic simulation model that simulates life histories for a sample of individuals born in a particular year starting from 1935. PENSIM uses waiting time survival models to model the events in life histories. PENSIM is a very rich simulation, it simulates events ranging from timing of marriage, schooling events, child birth for women, migration, disability, jobs characteristics and to pensions plans and coverage. | Survey of Income and Program Participation (SIPP), Panel Study of Income Dynamics (PSID) | continuous | open | |
| PRISM | US – ICF/Lewin Inc. | The current version of the Projected Retirement Income Simulation Model (PRISM) is the second major revision of the model that was first developed together by Lewin-ICF and the Brookings Institution in 1986 (Knickman and Snell, 2002). PRISM is now also part of a Long-term Care Model. This model simulates the utilization and financing of long-term care services for elderly individuals through 2050. PRISM simulates for each person future demographic characteristics, labour force participation, income and assets of the elderly. The Long-term Care Financing Model simulates disability, utilization of long term care, and methods of financing long-term care. | n = 28,000, various sources | discrete | closed | |
| MINT | US – Social Security Administration | The microsimulation model MINT has been developed by the US Social Security Administration. The model was mainly developed for the projection of retirement income for current and future benefits of an individual or a couple of the birth cohorts 1931–1960 (Toder et al., 1999). The model makes independent projections for each retiree’s income from Social Security benefits, pensions, assets, and earnings (Butrica et al., 2001: 3) | n = 113,500 1990–1993 Survey of Income and Program Participation (SIPP) | discrete | closed | |
| DYNASIM | US – Urban Institute | The DYNASIM “Dynamic Simulation of Income Model” was the first large-scale dynamic microsimulation model in social sciences. It was initially developed between 1969 and 1976 under the direction of Guy Orcutt at the Urban Institute (Orcutt, 1957). A second version – DYNASIM2 – was developed between 1979 and 1983. A third version – DYNASIM3 – was completed in 2004 and is based on 1990–1993 Survey of Income and Program Participation panels. Like in DYNASIM2, the main focus lies on pension simulations and issues of population aging. | DYNASIM3: n = 100,000 1990–1993 Survey of Income and Program Participation (SIPP) | discrete | closed | http://www.urban.org/ |
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