Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-03T08:01:51.676Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of Physician Services by Older Adults: 1991/1992 to 2000/2001

Published online by Cambridge University Press:  31 March 2010

Diane E. Watson ,
Petra Heppner ,
Robert Reid ,
Bogdan Bogdanovic  and
Noralou Roos
Diane E. Watson*
Affiliation:
University of British Columbia
Petra Heppner
Affiliation:
University of British Columbia
Robert Reid
Affiliation:
Group Health Cooperative of Puget Sound
Bogdan Bogdanovic
Affiliation:
University of Manitoba
Noralou Roos
Affiliation:
University of Manitoba
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Diane Watson, Ph.D., M.B.A., B.Sc.O.T., Centre for Health Services and Policy Research, University of British Columbia, 4th Floor, 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3. ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Canadians have expressed concern that access to family physicians (FP) has declined. Anonymized physician services data for 1991/1992 to 2000/2001 were used to evaluate changes in supply and age-specific rates of use of FPs and specialists in Winnipeg, Manitoba. Physician-to-population ratios declined 7.5 per cent, FP-to-population ratios declined 4.8 per cent, and specialist-to-population ratios declined 10.0 per cent. Among the general population, FP visit rates declined 3 per cent. Among older adults, physician visit rates increased 2.3 per cent, FP visit rates increased 10.9 per cent, and specialist visit rates declined 15.7 per cent. By comparison, we document declines in FP use by those younger than 5 years (25.5%) and those 6 to 19 years of age (18.6%). Increases in FP and declines in specialist use occurred primarily among those aged 65 to 84 years. By 2000/2001 older adults accounted for 25 per cent of all FP encounters. Gains in FP use among older adults was less attributable to the presence of more seniors and more related to the fact that a higher proportion of them are visiting a FP each year and, potentially, substituting primary for secondary care.

Résumé

Les Canadiens et Canadiennes ont exprimé des inquiétudes au sujet de la diminution de l'accès aux médecins de famille (MF). Des données sur les services fournis entre 1991/1992 et 2000/2001, par des médecins dont le nom n'a pas été divulgué, ont été utilisées pour évaluer les changements en matière d'effectifs disponibles ainsi que la fréquence des consultations de MF et de spécialistes, en fonction de l'âge des patients, à Winnipeg, au Manitoba. La proportion de médecins dans la population a diminué de 7,5 p. 100, celle de MF, de 4,8 p. 100 et celle de spécialistes, de 10,0 p. 100. Dans la population en général, la fréquence des visites chez des MF a diminué de 3 p. 100. Chez les personnes âgées, la fréquence des visites chez le médecin a augmenté de 2,3 p. 100, celle des visites chez des MF a augmenté de 10,9 p. 100 et celle des visites chez des spécialistes a diminué de 15,7 p. 100. Par comparaison, nous constatons des diminutions dans la consultation de MF chez les enfants de moins de cinq ans (25,5 p. 100) et chez les jeunes de 6 à 19 ans (18,6 p. 100). Des augmentations dans la consultation des MF et des diminutions dans la consultation des spécialistes ont surtout été constatées chez les personnes âgées de 65 à 84 ans. En 2000/2001, les personnes âgées représentaient 25 p. 100 de toutes les visites chez un MF. L'accroissement de la consultation des MF par des personnes âgées découle moins de la croissance du nombre d'aînés que du fait qu'ils sont plus nombreux à consulter un MF chaque année et, dans certains cas, à remplacer les soins primaires par des soins secondaires.

Keywords

family physiciansspecialistsservice utilizationphysician supplyagingmédecins de famillespécialistesutilisation des serviceseffectifs de médecinsvieillissement
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. 29 - 36
Copyright
Copyright © Canadian Association on Gerontology 2005

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.)

References

Barer, M.L., Evans, R.G., & Hertzman, C. (1995). Avalanche or glacier? Health care and the demographic rhetoric. Canadian Journal on Aging, 14, 193–224.CrossRefGoogle Scholar
Black, C., Roos, N.P., Havens, B., & MacWilliam, L. (1995). Rising use of physician services by the elderly: The contribution of morbidity. Canadian Journal on Aging, 14, 225–244.CrossRefGoogle Scholar
Bueckert, D. (1993, June 22). Foreign MDs limit backed in survey: Canadian doctors feel job crunch. Winnipeg Free Press, p.A2.Google Scholar
Chan, B. (2002). From perceived surplus to perceived shortage: What happened to Canada's physician workforce in the 1990s? Ottawa: Canadian Institute for Health Information.Google Scholar
Chen, J., & Millar, W.J. (2000). Are recent cohorts healthier than their predecessors? (Report No. 11-4). Ottawa: Statistics Canada.Google Scholar
Conference Board of Canada. (2001). Canadians' values and attitudes on Canada's health care system: A synthesis of survey results. Ottawa: Author.Google Scholar
Demers, M. (1996). Factors explaining the increase in cost for physician care in Quebec's elderly population. Canadian Medical Association Journal, 155, 1555–1623.Google Scholar
Evans, R.G., McGrail, K.M., Morgan, S.G., Barer, M.L., & Hertzman, C. (2001). Apolcalyse no: Population aging and the future of health care systems. Canadian Journal on Aging, 20 (Suppl. 1), 160–191.Google Scholar
Expert Panel on Health Professional Human Resources & Ministry of Health & Long Term Care. (2001). Shaping Ontario's physician workforce. Toronto: Author.Google Scholar
Eyles, J., Birch, S., & Newbold, K.B. (1995). Delivering the goods? Access to family physician services in Canada: A comparison of 1985 to 1991. Journal of Health and Social Behavior, 36, 322–332.Google Scholar
Freedman, V.A., Martin, L.G., & Schoeni, R.F. (2002). Recent trends in disability and functioning among older adults in the United States. Journal of the American Medical Association, 288, 3137–3146.Google Scholar
Fries, J.F. (1980). Aging, natural death and the compression of morbidity. New England Journal of Medicine, 303, 130–135.Google Scholar
Fries, J.F. (2002). Reducing disability in older age. Journal of the American Medical Association, 288, 3164–3165.Google Scholar
Health Canada. (2003). 2003 First ministers' accord on health care renewal. Retrieved February 24, 2003, from http://www.hc-sc.gc.ca/english/hca2003/accord.htmlGoogle Scholar
Iezzoni, L.I. (1997). The risks of risk adjustment. Journal of the American Medical Association, 278, 1600–1607.CrossRefGoogle ScholarPubMed
Jaakkimainen, L. (2001). Primary care visits: How many doctors do people see? Hospital Quarterly, 5(1), 17.Google ScholarPubMed
Martel, L., & Belanger, A. (2000). Dependency-free life expectancy in Canada (Report No. 11-008). Ottawa: Statistics Canada.Google Scholar
Menec, V.H., MacWilliam, L., Soodeen, R., & 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
POLLARA Research. (May 2002). Health Care in Canada Survey 2002. Retrieved March 24, 2003, from http://www.pollara.ca/new/Library/SURVEYS/Healthcare2002.pdfGoogle Scholar
Robinson, J.R., Young, T.K., Roos, L.L., & Gelskey, D.E. (1997). Estimating the burden of disease: Comparing administrative data and self-reports. Medical Care, 9, 932–947.CrossRefGoogle 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
Rosenberg, M.W., & James, A.M. (2000). Medical services utilization patterns by seniors. Canadian Journal on Aging, 19.1, 125–142.CrossRefGoogle Scholar
Sanmartin, C., Houle, C., Berthelot, J.M., & White, K. (2002). Access to health care services in Canada, 2001. Ottawa: Statistics Canada.Google Scholar
Standing Senate Committee on Social Affairs, Science and Technology. (2002). The health of Canadians: The federal role, final report (Rep. No. 6: Recommendations for Reform). Ottawa: Author.Google Scholar
Square, D. (2001). Manitoba increased medical school enrolment in attempt to fight doctor deficit. Canadian Medical Association Journal, 164, 395.Google Scholar
Watson, D.E., Bogdanovic, B., Heppner, P., Katz, A., Reid, R., & Roos, N.P. (2003). Supply, availability and use of family physicians in Winnipeg: 1991/92–2000/01. Winnipeg: Manitoba Centre for Health Policy.Google Scholar
Watson, D.E., Roos, N.P., Katz, A., & Bogdanovic, B. (2003). Is a 5% decline in physician supply significant? Yes or No. Canadian Family Physician, 49, 366–367.Google Scholar