Dynamic microsimulation of health care demand, health care finance and the economic impact of health behaviours: Survey and review

Abstract

This paper reviews the issues to be faced in attempting to create a microsimulation of health care demand, health care finance and the economic impact of health behaviour. These issues identified via an in-depth review of seven dynamic microsimulation models, selected from an initial set of 27 models in order to highlight the main differences in approaches and modelling options currently adopted. After presenting a brief description of each of the seven selected models, the main modelling approaches are summarized and critically appraised using five main distinguishing criteria. These criteria are the use of alignment techniques, model complexity (as reflected in the range of variables used), theoretical foundations, type of starting population, and the extent and detail of financial issues covered. Building upon this appraisal, the paper goes on to show how the '12 SAGE lessons' apply in the field of health care microsimulation. The trade-off between complexity and predictive power is shown to be key. Finally an appendix summarises the main features of all 27 of the dynamic microsimulation models originally surveyed.

Distributional Effects of the Forthcoming Finnish Pension Reform – a Dynamic Microsimulation Approach

“…of disease and the impact of health policies in relation to prevention or treatment (Wolfson, 1991;Evan et al, 2013). However, these models do not include detailed health care costs or enough tax data to address the implications of alternative financing options (Spielauer, 2007b;Decarie, 2011). The SPSD-Health has some limitations.…”

“…Internationally, several social policy microsimulation models such as DYNASIM3 and CORSIM, both developed in the US, include selected measures of health status, such as disability, and the need for institutional care but have limited functionality in terms of health care costs and implications of different financing options(Spielauer, 2007b;Urban Institute, 2015). More recently Parente and colleagues have assessed uptake of private health insurance and Medicaid following the United Stated Supreme Court decision to uphold the Affordable Care Act.…”

The evaluation of health policies through dynamic microsimulation methods

“…Several authors have discussed the relative merits of discrete-time versus continuous-time dynamic microsimulation modelling (Zaidi and Rake, 2001;Spielauer, 2007;Willekens 2009). Zaidi and Raike (2001) suggest that in principle a continuous-time framework should be preferred because it allows for intermediate (i.e.…”

“…Microsimulation is a relatively new statistical technique (Orcutt, 1957(Orcutt, , 1960) that has established itself as a method for the ex-ante evaluation of public policies (Creedy and Duncan, 2002;Creedy and Kalb, 2005;Spadaro, 2005;Bourguignon and Spadaro, 2006). The application of these techniques has, however, largely focused on simulating taxbenefit and pension systems and extensions to the evaluation of health and health-related policies is still limited (Spielauer, 2007). Microsimulation techniques simulate individual behavioural responses at a micro-level of policies yet to be implemented.…”

“…This paper builds on previous reviews (Spielauer, 2007) by offering a detailed description of a wide range of modelling features and their practical implementation with a particular emphasis on the dynamic and behavioural aspects of microsimulation. In addition, through a review of methods and applications, we also attempt to discuss and identify the types of health policy questions and interventions that can best be analysed through the use of dynamic microsimulation methods.…”