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Trends in the Utilization of Health Services by Seniors in Alberta*

Published online by Cambridge University Press:  29 November 2010

L. Duncan Saunders
Affiliation:
University of Alberta The Alberta Centre for Health Services Utilization Research
Arif Alibhai
Affiliation:
University of Alberta The Alberta Centre for Health Services Utilization Research
David B. Hogan
Affiliation:
The Alberta Centre for Health Services Utilization Research University of Calgary
Colleen J. Maxwell
Affiliation:
The Alberta Centre for Health Services Utilization Research University of Calgary
Hude Quan
Affiliation:
The Alberta Centre for Health Services Utilization Research University of Calgary
David Johnson
Affiliation:
The Alberta Centre for Health Services Utilization Research University of Saskatchewan.

Abstract

Ensuring the delivery of comprehensive, high quality programs and services to seniors in Canada over the coming decades presents a significant challenge to policy makers and health care professionals. The goal of this study was to provide decision-makers with data on recent trends in the utilization of health services by seniors in Alberta. We compared recent trends in the utilization of acute hospital services (1992/93–1997/98), home care services (1994/95–1997/98), claims for physician consultations and procedures (1995/96–1997/98) and long-term facility care (1990–1996) for Albertans less than and over 65 years of age. We also assessed trends in the use of prescription drugs (1992/93–1997–98) by Albertans 65 years and older. Data for these analyses were obtained from Alberta Health and Wellness administrative databases and reports. Overall, the trends indicate fewer, though sicker, patients being cared for in institutions and more patients being cared for in the community. The receipt of prescription drugs obtained outside of facilities has also increased among seniors in recent years. The extent and appropriateness of substitution of community care for institutional care, the quality of that care, and whether health outcomes are better, worse, or unchanged, are important subjects for further study.

Résumé

La prestation de services et de programmes exhaustifs et de qualité pour les aîné(e)s canadien(ne)s au cours des prochaines décennies représente un défi de taille pour les responsables des politiques et les professionnels des soins de santé. La présente étude visait à fournir aux décideurs des données actuelles sur l'utilisation des services de santé par les aîné(e)s en Alberta. Nous avons comparé les tendances en utilisation de services hospitaliers actifs (1992/93–1997/98), des services de soins à domicile (1994/95–1997/98), des demandes de règlement de consultations et de soins de médecins (1995/96–1997/98) et, des établissements de soins à long terme (1990–1996) pour les albertains de moins et de plus de 65 ans. Nous avons également évalué les tendances dans l'utilisation des médicaments presents (1992/93–1997/98) chez les albertains de 65 ans et plus. Les données des analyses proviennent des bases de données et des rapports du Alberta Health and Wellness. Dans l'ensemble, les tendances indiquent qu'un moins grand nombre de patients sont soignés en établissement mais qu'ils sont plus malades; aussi, un nombre plus important de patients est soigné dans la communauté. Les reçus de médicaments prescrits remis en dehors des établissements ont augmenté chez les aîné(e)s dans les dernières années. La portée et la pertinence de la substitution des soins en établissement par les soins dans la communauté, la qualité de ses soins et leurs répercussions sur l'amélioration, la détérioration ou le maintien de la santé constituent des thèmes importants d'études ultérieures.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2001

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References

1.Alberta Health. Population projections for Alberta and its health regions 1996–2016. Alberta Health: Health Surveillance Branch. April 1998.Google Scholar
2. In: Alberta Patterns of Provincial Government Health Expenditures by Gender and Age in Alberta in other Jurisdictions. Alberta Health: Health Economics Branch. March 1998.Google Scholar
3.Alberta Health. Healthy Albertans living in a healthy Alberta — a three-year Business plan: 94/95–96/97. Edmonton, February 1994.Google Scholar
4.Alberta Health News Release. Boundaries for 17 health regions finalized. Edmonton, April 21, 1994.Google Scholar
5.Alberta Health News Release. Regional Health Authority members appointed. Edmonton, June 9, 1997.Google Scholar
6.Alberta Health. Alberta Health Annual Report. 1998/1999.Google Scholar
7.Jacobs, P, Bay, K, Hall, E. RDRG V3.0 case and day Weights: A research report submitted to the technical working committee, Alberta Health. Department of Health Services Administration and Community Medicine, University of Alberta. 1993.Google Scholar
8.Alberta Health. Alberta resident classification system for long term care facilities: instructions for completing the resident classification form. Alberta Health, 1994.Google Scholar
9.Alberta Ministry of Health. Alberta Health Care Insurance Plan. Statistical Supplements 1992/93 to 1997/98.Google Scholar
10.Dryden, D, Donash Associates. Health services utilization in the population aged 65 and older: review of the literature. The Alberta Centre for Health Services Utilization Research. March 1999.Google Scholar
11.Bay, KS, Long, MJ, Ross Kerr, JC. Utilization of hospital services by the elderly: Geriatric crisis in one Canadian single payer system. Health Services Management Research 1997; 10:4257.CrossRefGoogle ScholarPubMed
12.Mossey, JM, Havens, B, Wolinsky, FD. The consistency of formal health care utilization: physician and hospital utilization. In Ory, MG, Bond, K, editors. Aging and healthcare: Social science and policy perspectives. London: Rout-ledge, 1989:8198.Google Scholar
13.Shapiro, E. Manitoba health care studies and their policy implications. Winnipeg: Manitoba Centre for Health Policy, 1991.Google Scholar
14.Evans, RG, Barer, ML, Hertzman, C, Anderson, GM, Pulcins, IR, Lomas, J. The long good-bye: The great transformation of the British Columbia hospital system. Health Services Research 1989; 24:435–59.Google Scholar
15.Barer, ML, Evans, RG, Hertzman, C. Avalanche or glacier? Health care and the demographic rhetoric. Canadian Journal on Aging 1995; 14:193224.CrossRefGoogle Scholar
16.Haan, MN, Selby, JV, Quesenberry, CP, Schmittdiel, JA, Fireman, BH, Rice, DP. The impact of aging and chronic disease on use of hospital and outpatient services in a large HMO: 1971–1991. J Am Geriatr Soc 1997; 45: 667–74.CrossRefGoogle Scholar
17.Demers, M. Factors explaining the increase in cost for physician care in Quebec's elderly population. CMAJ 1996; 155: 1555–60.Google ScholarPubMed
18.Katz, SJ, Welch, WP, Verrilli, D. The growth of physician services for the elderly in the United States and Canada: 1987–1992. Medical Care Research and Review 1997; 54: 301–20.CrossRefGoogle ScholarPubMed
19.Shaw, S. Continuing care services client profile: A comparison of continuing care centre residents and home care clients receiving long-term service: Discussion paper. Edmonton: Alberta Health, 1995.Google Scholar
20.Seniors Advisory Council for Alberta. Older Albertans 1992. Edmonton: Alberta Health, 1993.Google Scholar
21.DeCoster, C, Roos, NP, Bogdanovic, B. Utilization of nursing home resources. Medical Care 1995;33: DS7383.CrossRefGoogle ScholarPubMed
22.Tully, P, Mohl, C. Older residents of health care institutions. Health Reports 1995; 7:2730.Google ScholarPubMed
23.Gorecki, PK. Controlling drug expenditure in Canada — the Ontario experience. Ontario: Economic Council of Canada/Ontario Ministry of Health, 1992.Google Scholar
24.Anonymous. Seniors' drug costs continue to rise. DUE Quarterly 1996; 10:34.Google Scholar
25.Berlowitz, DR, Brandeis, GH, Moskowitz, MA. Using administrative databases to evaluate long-term care. J Am Geriatr Soc 1997; 45:618–23.CrossRefGoogle ScholarPubMed
26.Hirdes, JP, Botz, CA, Kozak, J, Lepp, V. Identifying an appropriate case mix measure for chronic care: Evidence from an Ontario pilot study. Healthcare Management Forum 1996;9(1):40–6.CrossRefGoogle ScholarPubMed
27.Fries, BE, Schneider, DP, Foley, WJ, Gavazzi, M, Burke, R, Cornelius, E. Refining a case-mix measure for nursing homes: Resource utilization groups (RUG-III). Medical Care 1994;32(7):668–85.CrossRefGoogle ScholarPubMed
28.Soderstrom, L, Tousignant, P, Kaufman, T. The health and cost effects of substituting home care for inpatient acute care: A review of the evidence. CMAJ 1999; 160:1151–5.Google ScholarPubMed
29.Haan, MN, Selby, JV, Quesenberry, CP, Schmittdiel, JA, Fireman, BH, Rice, DP. The impact of aging and chronic disease on use of hospital and outpatient services in a large HMO: 1971–1991. J Am Geriatr Soc 1997; 45:667–74.CrossRefGoogle Scholar
30.Saunders, LD, Alibhai, A, Hogan, DB, Maxwell, CJ, Quan, H, Johnson, D. Trends in the utilization of health services by seniors in Alberta. The Alberta Centre for Health Services Utilization Research. March 1999.Google Scholar
31.Bonita, R. Women, Aging and Health: Achieving health across the life span. Geneva: World Health Organization, 1996.Google Scholar
32.Prescott, E, Hippe, M, Schnohr, P, Hein, HO, Vestbo, J. Smoking and risk of myocardial infarction in women and men: Longitudinal population study. BMJ 1998; 9:9–7.Google Scholar
33.Maxwell, CJ, Kozak, JF, Desjardins-Denault, SD, Parboosingh, J. Factors important in promoting mammography screening among Canadian women. Can J Public Health 1997; 88:346–50.CrossRefGoogle ScholarPubMed
34.Wagner, EH. Why is health care use rising if morbidity is being compressed? J Am Geriatr Soc 1997; 45:768–9.CrossRefGoogle ScholarPubMed
35.Schneider, EL. Aging in the Third Millennium. Science 283;796–7.CrossRefGoogle Scholar