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Trends in the Utilization of Specific Health Care Services among Older Manitobans: 1985 to 2000

Published online by Cambridge University Press:  31 March 2010

Marcia Finlayson ,
Lisa Lix ,
Gregory S. Finlayson  and
Terry Fong
Marcia Finlayson*
Affiliation:
Department of Occupational Therapy, University of Illinois at Chicago Department of Community Health Sciences, University of Manitoba
Lisa Lix
Affiliation:
Department of Community Health Sciences, University of Manitoba
Gregory S. Finlayson
Affiliation:
Department of Community Health Sciences, University of Manitoba
Terry Fong
Affiliation:
Department of Occupational Therapy, University of Illinois at Chicago
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Marcia Finlayson, Ph.D., Department of Occupational Therapy, University of Illinois at Chicago,1919 West Taylor Street, Chicago, IL 60612-7250. ([email protected])
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Abstract

This paper examines 16-year trends in the utilization of hospital and physician services by Manitobans aged 75 and more, using data from the Manitoba Population Health Research Data Repository. Trends are examined across five measures of hospital services (separations, short-stay days, long-stay days, cataract surgeries, and hip/knee replacements) and two measures of physician care (overall visit rate, and proportion having seven or more visits). Results show changes in the utilization of these services among older adults living in Manitoba over time, with the extent of change varying with the service under consideration, age, and location of residence. Previously large utilization differentials are shown to be shrinking; for example, cataract surgery rates across regions and physician visit rates by age. For other services, such as the rates of hip or knee replacement surgery, the differences across regions are increasing. Findings indicate that global generalizations about the impact of older adults on the health care system are subject to question, as regional differences and differences between age groups (75–84, 85+) can be significant.

Résumé

Cet article porte sur les tendances 16 années en matière d'utilisation des hôpitaux et des services médicaux par des Manitobains âgés de 75 ans ou plus. Les données ont été tirées du Manitoba Population Health Research Data Repository. Les tendances sont étudiées en fonction de cinq mesures relatives aux services hospitaliers (les congés des hôpitaux, les séjours de courte durée, les séjours de longue durée, les opérations de la cataracte ainsi que les remplacements de la hanche ou du genou) de même que de deux mesures relatives aux soins prodigués par des médecins (le nombre global de consultations ainsi que la proportion de personnes qui ont sept consultations ou plus). Les résultats démontrent des changements, au cours du temps, dans l'utilisation de ces services par les personnes âgées vivant au Manitoba, l'étendue de ces changements variant selon le service étudié, l'âge et le lieu de résidence. Des différences autrefois considérables en matière d'utilisation sont en train de diminuer, notamment le taux d'opérations de la cataracte selon les régions ainsi que la fréquence des visites chez le médecin selon l'âge. Pour d'autres services, notamment le taux de remplacements de la hanche ou du genou, les différences entre les régions sont en train de s'accroître. Les résultats indiquent que les généralisations relatives à l'impact des personnes âgées sur le système de santé peuvent être remises en question, puisque les différences entre les régions et entre les groupes d'âge (75 à 84, 85 ou plus) peuvent être considérables.

Keywords

health services for the agedhospitalization, trends & utilizationphysician use, trends & utilizationcataract extraction, trends & utilizationorthopedic surgery, trends & utilizationagingsoins de santé pour les aînéshospitalisation : tendances et utilisationvisites chez le médecin : tendances et utilisationexcision de la cataracte : tendances et utilisationchirurgie orthopédique : tendances et utilisationvieillissement
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue S1: Health and Health Care Use Among Older Adults: Using Population-Based Information Systems to Inform Policy in Manitoba , Spring/Printemps 2005 , pp. 15 - 27
Copyright
Copyright © Canadian Association on Gerontology 2005

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References

Balasegaram, S., Majeed, A., & Fitz-Clarence, H. (2001). Trends in hospital admissions of the hip and femur in England, 1989–1990 to 1997–1998. Journal of Public Health Medicine, 23(1), 11–17.CrossRefGoogle ScholarPubMed
Barer, M.L., Evans, R.G., & Hertzman, C. (1995). Avalanche or glacier? Health care and demographic rhetoric. Canadian Journal on Aging, 14(2), 193–224.Google Scholar
Black, C., Roos, N.P., Havens, B., & MacWilliam, L. (1995). The rising use of physician services by the elderly: The contribution of morbidity. Canadian Journal on Aging, 14(2), 225–244.CrossRefGoogle Scholar
Blazer, D., Landerman, L., Fillenbaum, G., & Horner, R. (1995). Health services access and use among older adults in Northern Carolina: Urban vs. rural residents. American Journal of Public Health, 85(10), 1384–1390.CrossRefGoogle Scholar
Brownell, M., Roos, N.P., & Burchill, C. (1999). Monitoring the Winnipeg hospital system: 1990–91 through 1996–97. Winnipeg: Manitoba Centre for Health Policy and Evaluation.Google Scholar
Carrière, K.C., Roos, L.L., & Dover, D.C. (2000). Across time and space: Variations in hospital use during Canadian health reform. Health Services Research, 35(2), 467–487.Google ScholarPubMed
Chen, J., & Millar, W.J. (2000). Are recent cohorts healthier than their predecessors? Health Reports, 11(4), 9–23.Google ScholarPubMed
Chi, L., Brayne, C., Todd, C., & Pollitt, P. (1995). Predictors of hospital contact of very elderly people: A pilot study of a cohort of people aged 75 years and older. Age and Ageing, 24, 382–388.CrossRefGoogle Scholar
Dada, V.K., & Sindhu, N. (1999). Management of cataract: A revolutionary change that occurred during last two decades. Journal of the Indian Medical Association, 97(8), 313–317.Google Scholar
Dansky, K., Brannon, D., Shea, D., Vasey, J., & Dirani, R. (1998). Profiles of hospital, physician, and home health service use by older persons in rural areas. Gerontologist, 38(3), 320–330.Google Scholar
Doblhammer, G., & Kytir, J. (2001). Compression or expansion of morbidity? Trends in healthy life expectancy in the elderly Austrian population between 1978 and 1998. Social Science and Medicine, 52, 385–391.CrossRefGoogle ScholarPubMed
Dunn, O.J. (1961). Multiple comparisons among means. Journal of American Statistical Association, 56, 52–64.CrossRefGoogle Scholar
Gentleman, J.F., Vayda, E., Parsons, G.F., & Walsh, M.N. (1996). Surgical rates in subprovincial areas across Canada: Rankings of 39 procedures in order of variation. Canadian Journal of Surgery, 39(5), 361–367.Google ScholarPubMed
Hubert, H.B., Bloch, D.A., Oehlert, J.W., & Fries, J.F. (2002). Lifestyle habits and compression of morbidity. Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 57(6), M347–M351.Google Scholar
ICES Practice Atlas. (1996). Patterns of health care in Ontario, 1996. Toronto: Author.Google Scholar
Katz, B.P., Freund, D.A., Heck, D.A., Dittus, R.S., Paul, J.E., Wright, J., Coyte, P., Holleman, E., & Hawker, G. (1996). Demographic variation in the rate of knee replacement: A multi-year analysis. Health Services Research, 31(2), 125–140.Google ScholarPubMed
Liang, K.S., & Zeger, S.L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 78, 13–22.Google Scholar
Lix, L.M., Ekuma, O., Brownell, M., & Roos, L. (2004). A framework for modelling differences in regional mortality over time. Journal of Epidemiology and Community Health, 58(5), 420–425.Google Scholar
Lum, Y., Chang, H., & Ozawa, M. (1999). The effects of race and ethnicity on use of health services by older Americans. Journal of Social Services Research, 25(4), 15–42.CrossRefGoogle Scholar
Madhok, R., Lewallen, D.G., Wallrichs, S.L., Ilstrup, D.M., Kurkland, R.L., & Melton, L.J., 3rd. (1993). Trends in the utilization of primary total hip arthroplasty, 1969 through 1990: A population-based study in Olmstead County, Minnesota. Mayo Clinic Proceedings, 68, 11–18.CrossRefGoogle Scholar
Manitoba Bureau of Statistics. (2000). Winnipeg: Author. Manitoba Health Regions Population Projections June 1, 1998–June 1, 2025.Google Scholar
Menec, V.H., MacWilliam, L., Soodeen, R.A., & Mitchell, L. (2002). The health and health care use of Manitoba's seniors: Have they changed over time? Winnipeg: Manitoba Centre for Health Policy.Google Scholar
Robson, W.B.P. (2001). Will the baby boomers bust the health budget? Demographic change and health care financing reform. Ottawa: Renouf.Google Scholar
Roos, L.L., Fisher, E.S., Brazauskas, R., Sharp, S.M., & Shapiro, E. (1992). Health and surgical outcomes in Canada and the United States. Health Affairs (Millwood), 11(2), 56–72.CrossRefGoogle ScholarPubMed
Roos, L.L., Fisher, E.S., Sharp, S.M., Newhouse, J.P., Anderson, G., & Bubolz, T.A. (1990). Postsurgical mortality in Manitoba and New England. Journal of the American Medical Association, 263(18), 2453–2458.Google Scholar
Roos, L.L., Mustard, C.A., Nicol, J.P., McLerran, D.F., Malenka, D.J., Young, T.K., & Cohen, M.M. (1993). Registries and administrative data: Organization and accuracy. Medical Care, 31, 201–212.CrossRefGoogle ScholarPubMed
Roos, N.P., & Mustard, C. (1997). Variation in health and health care use by socio-economic status in Winnipeg, Canada: The system works well? Yes and no. Milbank Quarterly, 75(1), 89–111.Google Scholar
Roos, N.P., Shapiro, E., Bond, R., Black, C., Finlayson, G., Newburn-Cook, C., MacWilliam, L., Steinbach, C., Yogendran, M., & Walld, R. (2001). Changes in health and health care use of Manitobans, 1985–1998. Winnipeg: Manitoba Centre for Health Policy and Evaluation.Google Scholar
Saag, K., Doebbeking, B., Rohrer, J., Kolluri, S., Mitchell, T., & Wallace, R. (1998). Arthritis health service utilization among the elderly: The role of urban-rural residence and other utilization factors. Arthritis Care and Research, 11(3), 177–185.Google Scholar
Schwarz, K. (2000). Predictors of early hospital readmissions of older adults who are functionally impaired. Journal of Gerontological Nursing, 26(6), 29–36.CrossRefGoogle ScholarPubMed
Statistics Canada. 2004. CANSIM II table 0510001: Estimates of population, by age group and sex, Canada, provinces and territories. Retrieved January 19, 2004, from, http://cansim2.statcan.ca/cgi-win/CNSMCGI.EXEGoogle Scholar
Willis, C.E., Kee, F., Beverland, D., & Watson, J.D. (2000). Urban-rural differences in total hip replacements: The next stage. Journal of Public Health Medicine, 22(3), 435–438.CrossRefGoogle ScholarPubMed
Wolinsky, F., Stump, T., & Johnson, R. (1995). Hospital utilization profiles among older adults over time: Consistency and volume among survivors and decedents. Journal of Gerontology, 50B(2), S88–S100.Google Scholar