Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

This study examines national health expenditure trends for Japan, Canada, Australia, and England and Wales (combined) to assess the impact of changing demographics and changing age-specific per capita expenditure on national health expenditure. Age-specific expenditure data were obtained from each country's department of health. We calculated changes in age-specific per capita expenditure, population demographics and the share of expenditures used by the different age groups over time. We then determined the extent to which isolated changes in population growth, demographic shifts and changes in age-specific per capita expenditure could predict observed increases in health expenditure. For Japan, Canada and Australia per capita health expenditure increased fastest among those aged 65 and over, at up to twice the increase of those aged 45-64. In England and Wales, on the other hand, those aged 65 and over experienced one-third of the cost increase of those aged 45-64. Hence, the proportion of national health expenditures used by the population aged 65 and over decreased from 40% to 35% in England and Wales, while increasing in the other countries by up to 10 percentage points. Demographic shifts and population growth predicted only 18% of the observed increases in health care expenditures in England and Wales, compared to 68%, 44% and 34% for Japan, Canada and Australia respectively. These differential changes in costs for older age groups over time invite future research into the driving forces behind these costs.


Journal article


Appl Health Econ Health Policy

Publication Date





9 - 16


Adolescent, Adult, Age Distribution, Aged, Australia, Canada, Child, Child, Preschool, Developed Countries, England, Health Care Surveys, Health Expenditures, Humans, Infant, Infant, Newborn, Japan, Middle Aged, Population Dynamics, Wales