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- Articles and reports: 82-003-X201301011873Geography: CanadaDescription:
A computer simulation model of physical activity was developed for the Canadian adult population using longitudinal data from the National Population Health Survey and cross-sectional data from the Canadian Community Health Survey. The model is based on the Population Health Model (POHEM) platform developed by Statistics Canada. This article presents an overview of POHEM and describes the additions that were made to create the physical activity module (POHEM-PA). These additions include changes in physical activity over time, and the relationship between physical activity levels and health-adjusted life expectancy, life expectancy and the onset of selected chronic conditions. Estimates from simulation projections are compared with nationally representative survey data to provide an indication of the validity of POHEM-PA.
Release date: 2013-10-16 - Articles and reports: 11-522-X20020016722Geography: CanadaDescription:
Colorectal cancer (CRC) is the second cause of cancer deaths in Canada. Randomized controlled trials (RCT) have shown the efficacy of screening using faecal occult blood tests (FOBT). A comprehensive evaluation of the costs and consequences of CRC screening for the Canadian population is required before implementing such a program. This paper evaluates whether or not the CRC screening is cost-effective. The results of these simulations will be provided to the Canadian National Committee on Colorectal Cancer Screening to help formulate national policy recommendations for CRC screening.
Statistics Canada's Population Health Microsimulation Model was updated to incorporate a comprehensive CRC screening module based on Canadian data and RCT efficacy results. The module incorporated sensitivity and specificity of FOBT and colonoscopy, participation rates, incidence, staging, diagnostic and therapeutic options, disease progression, mortality and direct health care costs for different screening scenarios. Reproducing the mortality reduction observed in the Funen screening trial validated the model.
Release date: 2004-09-13 - 3. Modeling the burden of cancer in Canada ArchivedArticles and reports: 82-005-X20020016479Geography: CanadaDescription:
The Population Health Model (POHEM) is a policy analysis tool that helps answer "what-if" questions about the health and economic burden of specific diseases and the cost-effectiveness of administering new diagnostic and therapeutic interventions. This simulation model is particularly pertinent in an era of fiscal restraint, when new therapies are generally expensive and difficult policy decisions are being made. More important, it provides a base for a broader framework to inform policy decisions using comprehensive disease data and risk factors. Our "base case" models comprehensively estimate the lifetime costs of treating breast, lung and colorectal cancer in Canada. Our cancer models have shown the large financial burden of diagnostic work-up and initial therapy, as well as the high costs of hospitalizing those dying of cancer. Our core cancer models (lung, breast and colorectal cancer) have been used to evaluate the impact of new practice patterns. We have used these models to evaluate new chemotherapy regimens as therapeutic options for advanced lung cancer; the health and financial impact of reducing the hospital length of stay for initial breast cancer surgery; and the potential impact of population-based screening for colorectal cancer. To date, the most interesting intervention we have studied has been the use of tamoxifen to prevent breast cancer among high risk women.
Release date: 2002-10-08 - Articles and reports: 11F0019M1997099Geography: CanadaDescription:
Context : Lung cancer has been the leading cause of cancer deaths in Canadian males for many years, and since 1994, this has been the case for Canadian femalesas well. It is therefore important to evaluate the resources required for its diagnosis and treatment. This article presents an estimate of the direct medical costsassociated with the diagnosis and treatment of lung cancer calculated through the use of a micro-simulation model. For disease incidence, 1992 was chosen as thereference year, whereas costs are evaluated according to the rates that prevailed in 1993.Methods : A model for lung cancer has been incorporated into the Population Health Model (POHEM). The parameters of the model were drawn in part fromStatistics Canada's Canadian Cancer Registry (CCR), which provides information on the incidence and histological classification of lung cancer cases in Canada.The distribution of cancer stage at diagnosis was estimated by using information from two provincial cancer registries. A team of oncologists derived "typical" treatment approaches reflective of current practice, and the associated direct costs were calculated for these approaches. Once this information and the appropriatesurvival curves were incorporated into the POHEM model, overall costs of treatment were estimated by means of a Monte Carlo simulation.Results: It is estimated that overall, the direct medical costs of lung cancer diagnosis and treatment were just over $528 million. The cost per year of life gained as aresult of treatment of the disease was approximately $19,450. For the first time in Canada, it was possible to estimate the five year costs following diagnosis, bystage of the disease at the time of diagnosis. It was possible to estimate the cost per year of additional life gained for three alternative treatments of non small-cell lungcancer (NSCLC). Sensitivity analyses showed that these costs varied between $1,870 and $6,860 per year of additional life gained, which compares favourablywith the costs that the treatment of other diseases may involve.Conclusions: Contrary to widespread perceptions, it appears that the treatment of lung cancer is effective from an economic standpoint. In addition, the use of amicro-simulation model such as POHEM not only makes it possible to incorporate information from various sources in a coherent manner but also offers thepossibility of estimating the effect of alternative medical procedures from the standpoint of financial pressures on the health care system.
Release date: 1997-04-22 - Articles and reports: 11F0019M1995081Geography: CanadaDescription:
Users of socio-economic statistics typically want more and better information. Often, these needs can be met simply by more extensive data collections, subject to usual concerns over financial costs and survey respondent burdens. Users, particularly for public policy purposes, have also expressed a continuing, and as yet unfilled, demand for an integrated and coherent system of socio-economic statistics. In this case, additional data will not be sufficient; the more important constraint is the absence of an agreed conceptual approach.
In this paper, we briefly review the state of frameworks for social and economic statistics, including the kinds of socio-economic indicators users may want. These indicators are motivated first in general terms from basic principles and intuitive concepts, leaving aside for the moment the practicalities of their construction. We then show how a coherent structure of such indicators might be assembled.
A key implication is that this structure requires a coordinated network of surveys and data collection processes, and higher data quality standards. This in turn implies a breaking down of the "stovepipe" systems that typify much of the survey work in national statistical agencies (i.e. parallel but generally unrelated data "production lines"). Moreover, the data flowing from the network of surveys must be integrated. Since the data of interest are dynamic, the proposed method goes beyond statistical matching to microsimulation modeling. Finally, these ideas are illustrated with preliminary results from the LifePaths model currently under development in Statistics Canada.
Release date: 1995-07-30 - Articles and reports: 11F0019M1995067Geography: CanadaDescription:
The role of technical innovation in economic growth is both a current matter of keen public policy interest, and active exploration in economic theory. However, formal economic theorizing is often constrained by considerations of mathematical tractability. Evolutionary economic theories which are realized as computerized microsimulation models offer significant promise both for transcending mathematical constraints and addressing fundamental questions in a more realistic and flexible manner. This paper sketches XEcon, a microsimulation model of economic growth in the evolutionary tradition.
Release date: 1995-06-30
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- Articles and reports: 82-003-X201301011873Geography: CanadaDescription:
A computer simulation model of physical activity was developed for the Canadian adult population using longitudinal data from the National Population Health Survey and cross-sectional data from the Canadian Community Health Survey. The model is based on the Population Health Model (POHEM) platform developed by Statistics Canada. This article presents an overview of POHEM and describes the additions that were made to create the physical activity module (POHEM-PA). These additions include changes in physical activity over time, and the relationship between physical activity levels and health-adjusted life expectancy, life expectancy and the onset of selected chronic conditions. Estimates from simulation projections are compared with nationally representative survey data to provide an indication of the validity of POHEM-PA.
Release date: 2013-10-16 - Articles and reports: 11-522-X20020016722Geography: CanadaDescription:
Colorectal cancer (CRC) is the second cause of cancer deaths in Canada. Randomized controlled trials (RCT) have shown the efficacy of screening using faecal occult blood tests (FOBT). A comprehensive evaluation of the costs and consequences of CRC screening for the Canadian population is required before implementing such a program. This paper evaluates whether or not the CRC screening is cost-effective. The results of these simulations will be provided to the Canadian National Committee on Colorectal Cancer Screening to help formulate national policy recommendations for CRC screening.
Statistics Canada's Population Health Microsimulation Model was updated to incorporate a comprehensive CRC screening module based on Canadian data and RCT efficacy results. The module incorporated sensitivity and specificity of FOBT and colonoscopy, participation rates, incidence, staging, diagnostic and therapeutic options, disease progression, mortality and direct health care costs for different screening scenarios. Reproducing the mortality reduction observed in the Funen screening trial validated the model.
Release date: 2004-09-13 - 3. Modeling the burden of cancer in Canada ArchivedArticles and reports: 82-005-X20020016479Geography: CanadaDescription:
The Population Health Model (POHEM) is a policy analysis tool that helps answer "what-if" questions about the health and economic burden of specific diseases and the cost-effectiveness of administering new diagnostic and therapeutic interventions. This simulation model is particularly pertinent in an era of fiscal restraint, when new therapies are generally expensive and difficult policy decisions are being made. More important, it provides a base for a broader framework to inform policy decisions using comprehensive disease data and risk factors. Our "base case" models comprehensively estimate the lifetime costs of treating breast, lung and colorectal cancer in Canada. Our cancer models have shown the large financial burden of diagnostic work-up and initial therapy, as well as the high costs of hospitalizing those dying of cancer. Our core cancer models (lung, breast and colorectal cancer) have been used to evaluate the impact of new practice patterns. We have used these models to evaluate new chemotherapy regimens as therapeutic options for advanced lung cancer; the health and financial impact of reducing the hospital length of stay for initial breast cancer surgery; and the potential impact of population-based screening for colorectal cancer. To date, the most interesting intervention we have studied has been the use of tamoxifen to prevent breast cancer among high risk women.
Release date: 2002-10-08 - Articles and reports: 11F0019M1997099Geography: CanadaDescription:
Context : Lung cancer has been the leading cause of cancer deaths in Canadian males for many years, and since 1994, this has been the case for Canadian femalesas well. It is therefore important to evaluate the resources required for its diagnosis and treatment. This article presents an estimate of the direct medical costsassociated with the diagnosis and treatment of lung cancer calculated through the use of a micro-simulation model. For disease incidence, 1992 was chosen as thereference year, whereas costs are evaluated according to the rates that prevailed in 1993.Methods : A model for lung cancer has been incorporated into the Population Health Model (POHEM). The parameters of the model were drawn in part fromStatistics Canada's Canadian Cancer Registry (CCR), which provides information on the incidence and histological classification of lung cancer cases in Canada.The distribution of cancer stage at diagnosis was estimated by using information from two provincial cancer registries. A team of oncologists derived "typical" treatment approaches reflective of current practice, and the associated direct costs were calculated for these approaches. Once this information and the appropriatesurvival curves were incorporated into the POHEM model, overall costs of treatment were estimated by means of a Monte Carlo simulation.Results: It is estimated that overall, the direct medical costs of lung cancer diagnosis and treatment were just over $528 million. The cost per year of life gained as aresult of treatment of the disease was approximately $19,450. For the first time in Canada, it was possible to estimate the five year costs following diagnosis, bystage of the disease at the time of diagnosis. It was possible to estimate the cost per year of additional life gained for three alternative treatments of non small-cell lungcancer (NSCLC). Sensitivity analyses showed that these costs varied between $1,870 and $6,860 per year of additional life gained, which compares favourablywith the costs that the treatment of other diseases may involve.Conclusions: Contrary to widespread perceptions, it appears that the treatment of lung cancer is effective from an economic standpoint. In addition, the use of amicro-simulation model such as POHEM not only makes it possible to incorporate information from various sources in a coherent manner but also offers thepossibility of estimating the effect of alternative medical procedures from the standpoint of financial pressures on the health care system.
Release date: 1997-04-22 - Articles and reports: 11F0019M1995081Geography: CanadaDescription:
Users of socio-economic statistics typically want more and better information. Often, these needs can be met simply by more extensive data collections, subject to usual concerns over financial costs and survey respondent burdens. Users, particularly for public policy purposes, have also expressed a continuing, and as yet unfilled, demand for an integrated and coherent system of socio-economic statistics. In this case, additional data will not be sufficient; the more important constraint is the absence of an agreed conceptual approach.
In this paper, we briefly review the state of frameworks for social and economic statistics, including the kinds of socio-economic indicators users may want. These indicators are motivated first in general terms from basic principles and intuitive concepts, leaving aside for the moment the practicalities of their construction. We then show how a coherent structure of such indicators might be assembled.
A key implication is that this structure requires a coordinated network of surveys and data collection processes, and higher data quality standards. This in turn implies a breaking down of the "stovepipe" systems that typify much of the survey work in national statistical agencies (i.e. parallel but generally unrelated data "production lines"). Moreover, the data flowing from the network of surveys must be integrated. Since the data of interest are dynamic, the proposed method goes beyond statistical matching to microsimulation modeling. Finally, these ideas are illustrated with preliminary results from the LifePaths model currently under development in Statistics Canada.
Release date: 1995-07-30 - Articles and reports: 11F0019M1995067Geography: CanadaDescription:
The role of technical innovation in economic growth is both a current matter of keen public policy interest, and active exploration in economic theory. However, formal economic theorizing is often constrained by considerations of mathematical tractability. Evolutionary economic theories which are realized as computerized microsimulation models offer significant promise both for transcending mathematical constraints and addressing fundamental questions in a more realistic and flexible manner. This paper sketches XEcon, a microsimulation model of economic growth in the evolutionary tradition.
Release date: 1995-06-30
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