The Balance of Care in an Ageing Society (BCASO)




Health Research Council of New Zealand


Peter Davis, Roy Lay-Yee, Janet Pearson, Oliver Mannion, Gerry Cotterell, Martin von Randow, Jessica McLay


University of Auckland: Ngaire Kerse, Andrew Sporle, David O'Sullivan

National Centre for Social and Economic Modelling: Laurie Brown


The overall aim of this study was to model and quantify a range of policy scenarios on the future shape of the health sector – a focus prompted by the imminence of demographic ageing. This was done with a computational model to represent primary care in an ageing society. New modules developed focused on two strategic areas: the balance of care (focus, location; roles, responsibilities) and the impact of long-term, disabling, and chronic conditions, particularly those affecting older people.

The demographic shape of New Zealand is changing as birth rates decline to sub-replacement levels and life expectancy steadily increases. The outcome of the joint effect of these two processes is to greatly increase the proportion of the population in the older age groups. This has prompted debate about the likely impact of these developments on the provision of services and other support for this sector of the community. While there is little dispute about the numbers, there is more contention about health need. Thus, for some, greater life expectancy for older people will be spent largely in good health, while for others this extended period of life is more likely to be a time of significant morbidity, disability and dependency.


Lay-Yee R, Pearson J, Davis P, von Randow M, Kerse N, Brown L (2017). Changing the balance of social care for older people: Simulating scenarios under demographic ageing in New Zealand. Health & Social Care in the Community.

Lay-Yee R, Pearson J, Davis P, von Randow M, Kerse N, Brown L (2016). Rebalancing health service use for older people: simulating policy-relevant scenarios under demographic ageing. New Zealand Medical Journal 129(1442): 25–35.

Lay-Yee R, Pearson J, von Randow M (2016). Balance of Care in an Ageing Society: Construction of the BCASo microsimulation model. Centre of Methods and Policy Application in the Social Sciences (COMPASS), the University of Auckland.


Lay-Yee R (2014). Rebalancing Health and Social Care for Older People: Simulating Policy Options.