Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-26T17:47:35.940Z Has data issue: false hasContentIssue false
  • English
  • Français

Dementia in Ontario: Prevalence and Health Services Utilization*

Published online by Cambridge University Press:  31 March 2010

J.E. Tranmer ,
R. Croxford  and
P.C. Coyte
J.E. Tranmer
Affiliation:
Department of Health Policy, Management and Evaluation, University of Toronto
R. Croxford
Affiliation:
Clinical Epidemiology Unit, Sunnybrook and Women's College Health Sciences Centre Home and Community Care Evaluation and Research Centre, University of Toronto
P.C. Coyte*
Affiliation:
Department of Health Policy, Management and Evaluation, University of Toronto Clinical Epidemiology Unit, Sunnybrook and Women's College Health Sciences Centre Home and Community Care Evaluation and Research Centre, University of Toronto CHSRF/CIHR Health Services Chair, University of Toronto Institute for Clinical Evaluative Sciences, Toronto
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Peter C. Coyte, Ph.D., Department of Health Policy Management and Evaluation, McMurrich Building, 2nd Floor, 12 Queen's Park Crescent, Toronto, ON M5S 1A8, Tel.: (416) 978-8369, Fax: (416) 978-7350. ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

To understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using linked administrative databases to determine the incremental use of health services by elderly Ontarians with dementia. Overall, study results demonstrated that individuals with dementia used services in a pattern similar to non-demented persons, albeit at a higher level. Exceptions were women's use of hospital and home care services, where the most elderly women received significantly fewer services. Thus, the study provided important insight regarding the relative levels of health services used by demented Ontarians. Research in this area will become increasingly important as the population ages and the settings integral to dementia care and management shift and evolve.

Résumé

Pour comprendre l'importance de la réforme permanente des services de santé mentale et des soins aux personnes atteintes de démence en Ontario, il faut mettre en parallèle la prévalence de la maladie et les taux d'utilisation des services de santé. Le nombre de travaux de recherche consacrés à la démence en Ontario est insuffisant en regard de la prévalence. Pour pallier cette lacune, nous avons utilisé des bases de données administratives apparentées pour tracer la courbe de consommation des services de santé chez les aînés ontariens atteints de démence. Globalement, les conclusions de l'étude révèlent que les personnes atteintes de démence utilisent les services comme les autres patients, bien que de façon plus intensive. Par contre, on note de grands écarts sur le plan de la consommation des services en établissement et à domicile par les femmes ; les aînées les plus âgées recevant, en effet, beaucoup moins de services. L'étude jette un éclairage intéressant sur les niveaux relatifs de consommation des services de santé par les Ontariens atteints de démence. Ce type de recherche sera de plus en plus important compte tenu du vieillissement de la population et de l'évolution des milieux de soins et de gestion de la démence.

Keywords

dementiaAlzheimer's diseaseprevalencehealth services utilizationcost of illnessagingdémencemaladie d'Alzheimerprévalenceconsommation des services de santécoût de la maladievieillissement
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 22 , Issue 4 , Winter/Hiver 2003 , pp. 369 - 379
Copyright
Copyright © Canadian Association on Gerontology 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This article was presented to the Organization for Economic Cooperation and Development (OECD) at the Expert Meeting on Dementia in Paris, November 2002. The authors would like to thank the OECD for funding and the meeting participants for their comments. We would also like to acknowledge input from P. Rochon, K. Sykora, P. Goering, and C. Dewa. The article was presented as a paper at the International Health Economics Association World Congress, San Francisco, CA, 2003. The Institute for Clinical Evaluative Studies is funded by the Ontario Ministry of Health and Long-Term Care. The opinions, results, and conclusions that follow are those of the authors, and no endorsement by the Ministry of Health and Long-Term Care or by the Institute for Clinical Evaluative Sciences is intended or should be inferred.

References

1Ontario's strategy for Alzheimer disease and related dementias: Preparing for our Future. Toronto: Government of Ontario, Ministry of Health and Long-term Care; 1999.Google Scholar
2Project specifications: OECD case study on dementia. Paris: Organization for Economic Co-operation and Development; 2002.Google Scholar
3Putting people first: the reform of the mental health services in Ontario. Toronto: Ministry of Health and Long-term Care; 1999.Google Scholar
4Newman, D. A report on the consultative review of mental health reform in the province of Ontario. Toronto: Ministry of Health and Long-term Care; 1988.Google Scholar
5Taylor, DH Jr., Schenkman, M, Zhou, J, Sloan, FA. The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Gerontol B Psychol Sci Soc Sci 2001;56:S285–S293.CrossRefGoogle ScholarPubMed
6Sloan, FA, Taylor, DH Jr.. Effect of Alzheimer disease on the cost of treating other diseases. Alzheimer Dis Assoc Disord 2002;16(3):137–143.CrossRefGoogle ScholarPubMed
7Taylor, DH Jr., Sloan, FA. How much do persons with Alzheimer's disease cost Medicare? J Am Geriatr Soc 2000;48:639–646.CrossRefGoogle ScholarPubMed
8Lin, E, Goering, P. Fee-for-service core mental health services: Changes in provider source and visit frequency. Toronto: Institute for Clinical Evaluative Sciences; 2000.Google Scholar
9Statistics Canada. 1996 Census of Canada. Ottawa: Industry Canada; 1997.Google Scholar
10Taylor, DH Jr, Fillenbaum, GG, Ezell, ME. The accuracy of Medicare claims data in identifying Alzheimer's disease. J Clin Epidemiol 2002;55:929–937.CrossRefGoogle ScholarPubMed
11Coyte, PC, Croxford, R, Asche, CV, To, T, Feldman, W, Friedberg, J. Physician and population determinants of rates of middle-ear surgery in Ontario. JAMA 2001;286:2128–2135.CrossRefGoogle ScholarPubMed
12Laporte, A, Coyte, PC, Croxford, R. Access to home care services in Ontario: the role of socio-economic status. Toronto: Comparative Program on Health and Society 2001–2002 Working Paper Series; 2002.Google Scholar
13Nagelkerke, NJ. A note on a general definition of the coefficient of determination. Biometrika 1991;78:691–692.CrossRefGoogle Scholar
14Wetmore, S, Feightner, J, Gass, D, Worrall, G. Canadian consensus conference on dementia: summary of the issues and key recommendations. Can Fam Physician 1999;45:2136–2140, 2143, 2154–2159.Google ScholarPubMed
15McDowell, I. Alzheimer's disease: insights from epidemiology. Aging Clin Exp Res 2001;13(3):143–162.CrossRefGoogle ScholarPubMed
16McDowell, I, Hill, G, Lindsay, J, Helliwell, B, Chappell, N, Tuokko, H, et al. The incidence of dementia in Canada. Neurology 2000;55(1):66–73.Google Scholar
17McDowell, I, Hill, G, Lindsay, J. An overview of the Canadian Study of Health and Aging. Int Psychogeriatr 2001;13(supp. 1):7–18.CrossRefGoogle ScholarPubMed
18Coyte, PC, Hawker, G, Croxford, R, Attard, C, Wright, JG. Variation in rheumatologists' and family physicians' perceptions of the indications for and outcomes of knee replacement surgery [comment]. J Rheumatol 1996;23:730–738.Google Scholar
19Alter, DA, Naylor, CD, Austin, P, Tu, JV. Effects of socio-economic status on access to invasive cardiac procedures and on mortality after acute myocardial infarction. N Engl J Med 1999;341:1359–1367.CrossRefGoogle Scholar
20Mamdani, MM, Tu, K, Austin, PC, Alter, DA. Influence of socioeconomic status on drug selection for the elderly in Canada. Ann Pharmacother 2002;36:804–808.CrossRefGoogle ScholarPubMed