Ageing-related Diseases Project

Expenditure on health care for older persons accounts for between 35 and 50% of total health expenditure. The Ageing Related Diseases (ARD) project, started in spring 1999, focuses on diseases of high cost, high prevalence and considerable health implications to older populations. We employ a unique approach to comparing countries' health care systems by focusing on how they treat a few diseases that use a significant portion of the resources invested in those systems.

For each disease studied (ischaemic heart disease, breast cancer and stroke), we examine how variations in diagnosis and treatment are influenced by institutional structures and economic incentives, and what the implications are in terms of health outcomes and health expenditure. We have made use of a wide variety of available information sources including surveys, disease and death registers and nationally representative hospital discharge databases. The goal is to draw upon the analyses and information gathered from each of the three disease studies to better understand the links between the underlying institutional and health policy structures, and health care performance.

The project has relied on the extensive and active participation of over 150 experts from 21 OECD countries. Several countries chose to participate in more than one disease study; 17 countries participated in the ischaemic heart disease part, 12 countries for breast cancer and 16 countries for stroke. The project has benefited from the support of the United States National Institute on Ageing, with additional support from the Ministry of Health, Labour and Welfare in Japan.

A workshop was held on June 20-21 to discuss the implications of the ARD study. A publication of the workshop proceedings, building on the results of the project, will follow. Presentations from the conference (in .pdf format) can be found here.

A general introduction for the project, together with three reports discussing the results of the three disease studies, has been prepared:

• Project introduction
• Summary of results from breast cancer disease study
• Summary of the ischaemic heart disease study
• Summary of results from stroke disease study

Several documents have been made available over the Web, as part of the technical research materials developed for this project:

• The interplay of health policy, incentives and regulations in the treatment of ageing-related diseases
• Medical and epidemiological background
• Using hospital administrative databases for a disease-based approach to studying health care systems