1. An Historical Study of Trends in Medical Schemes in South Africa: 1974 to 1999
Prepared by Preeta Rama and Heather McLeod
This monograph presents a pictorial overall view of
private-sector medical schemes in South Africa over the period 1974-1999. The
material is the result of the compilation of a database using the Annual Reports
of the Registrar of Medical Schemes and statutory Registrars returns.
[Full text (371 KB)]
2. An Investigation into Healthcare Costs in the Last-Year-of-Life
Prepared by Prabashini Moodley and Heather McLeod
Health costs are shown in USA studies to be highest in the last year of life. This monograph examine studies from other parts of the world, to determine a methodology to apply to South African data. The methodology is applied to eight medical schemes over a four year period, 1997 to 2000. The data
are also used to investigate the ratio of medical costs of those who died to those who survived.
[Full text (287 KB)]
equalisation methodologies: an international perspective
Prepared by Neil Parkin and Heather McLeod
order to preserve social solidarity in healthcare, governments impose regulation
of health funders to entrench community rating and open enrolment.
Community rating and open enrolment are normally accompanied by
mechanisms for risk equalisation between the funds operating in that market.
This monograph provides details of a selection of the risk-equalisation
methodologies in use internationally in 2001, and describes their role within
the relevant health systems.
text (482 KB)]
4. The Impact of AIDS on Orphanhood in South Africa: A Quantitative analysis
Prepared by Leigh Johnson and Rob Dorrington
purpose of this monograph is to present an analysis of the impacts of the
HIV/AIDS epidemic on the number of orphans in South Africa. The primary focus of
the monograph is on the quantification of the orphan population, and the
ASSA2000 Orphans model is presented as a tool for projecting the size and
demographic profile of this population. Numbers of orphans are projected under
various scenarios, and the capacity of the South African system to deal with the
growth in orphan numbers is briefly assessed.
[Full text (304 KB)]
6. An Analysis of the Competitive Environment for Low-Cost Options in Medical Schemes
Prepared by Shivani Ranchod, Heather McLeod and Samora Adams
This monograph presents a working definition of low-cost options and considers the need for these options in medical schemes in South Africa. Detail is provided of the products currently available in the market. The distinguishing characteristics of theses options are identified, in particular their use of capitation and risk-sharing agreements with providers. The need for even lower cots products is identified and recommendations are made for their design.
[Full text (361 KB)]
7. Chronic Medicine Benefits in Medical Schemes:
of Benefit Design in 2001 and Changes since the Introduction of the Medical
Schemes Act, 1998
Prepared by Shivani Ranchod and Heather McLeod
This monograph considers the changes in chronic medicine benefits in open medical schemes over the period 1999 to 2001. Details of current chronic medicine benefit design are given and an example of innovative thinking in the design of a restricted medical scheme is discussed.
[Full text (284 KB)]
8. HIV Risk Factors: A Review of the Demographic, Socio-economic, Biomedical
and Behavioural Determinants of HIV Prevalence in South Africa
Prepared by Leigh Johnson and Debbie Budlender
purpose of this monograph is to identify the most significant demographic,
socio-economic, biomedical and behavioural determinants of HIV risk in South
Africa. It also aims to determine the relationships between these factors, and
to show how these factors apply in workforce populations. It combines a
literature review of studies conducted in South Africa into the effects of
various factors on rates of HIV infection, and a statistical analysis of four
major South African data sets.
text (331 KB)]
10. The Cover Provided for HIV/AIDS Benefits in Medical Schemes in 2002
Prepared by Andrew Stein, Heather McLeod and Zackie Achmat
The monograph presents the findings of a survey carried out amongst medical
schemes to investigate the extent and nature of the beneftis covering HIV/AIDS
provided by medical schemes. The research is of particular relevance to policy
makers interested in deciding the coverage of a Prescribed Minimum Benefits
[Full text (405 KB)]
11. Estimation of
mortality using the South African Census 2001 data
Prepared by Rob Dorrington, Tom Moultrie and Ian Timæus
This monograph derives estimates of recent mortality in South Africa taking into
account the most recent demographic data gathered by the
2001 census. Various deficiencies in the census data and the extensive editing
thereof are highlighted, leading to the conclusion that it is not possible to
produce reliable estimates of infant and child mortality from these data.
However, adult mortality rates were produced (for each sex, nationally, by
population group and by province) by making use of the deaths from the
population register together with those reported by households in the census and
the census population estimates. These rates show a clearly increasing trend in
mortality rates, concentrated in specific age groups that are strongly
suggestive of the increases that one might expect due to the impact of HIV/AIDS
on mortality. The report concludes by presenting illustrative life tables
together with probable maxima and minima for various commonly used indices of
[Full text (1.00 MB)]
12. Estimation of
fertility from the South African Census 2001 data
Prepared by Tom Moultrie and Rob Dorrington
This monograph presents estimates of fertility from the South African census
conducted in 2001. The quality of the data on women's lifetime and recent
fertility are subjected to strenuous examination, and are found to be uniformly
(and severely so) deficient. Extensive use was made of imputation rules, which
are shown to be biased on many dimensions. Careful application of various direct
and indirect techniques to the data results in estimates of fertility that are
robust and plausible, insofar as the resulting age distribution of fertility is
found to be fundamentally similar to that estimated from earlier demographic
sources (the 1996 Census and the 1998 DHS) and the levels of fertility represent
the continuation of previously identified trends.Estimates of fertility are
derived for each population group, and by province. The national level of
fertility is estimated to be 2.8 children per woman in 2001.
[Full text (492 KB)]
13. Alternative South African mid-year
Prepared by Rob Dorrington
The 2013 series of mid–year estimates (OffMYE) of the population of South Africa released byStats SA in May 2013 have’ as is shown in the figure below’ an age–distribution that is very different from that of the 2011 Census’ particularly for ages under 40. Despite Stats SA’ sassurances that "neither source is more right than the other; (because) they serve different purposes" there is concern in many quarters about the consequences of estimating and planning on the basis of an incorrect age distribution. Thus it was decided to produce an alternative set of mid–year estimates (AltMYE) that are similar in magnitude to the official mid–year estimates but maintain an age distribution that is consistent with that of the 2011 Census to allow users to check if the alternative age distribution has a significant impact on their estimates or
interpretation of trends over time.
[Full text (620 KB)]
[Excel Data File (620 KB)]