Utilization of hospital services by the elderly: geriatric crisis in one Canadian single payer system Export

@article{Bay1997, abstract = {As the number and proportion of elderly persons in the Canadian population increase, utilization of health services by the elderly becomes a growing concern for health service insurers, financial managers and policy makers, as well as for care providers. The purpose of this paper is to present the results of a study to analyse the use of hospital services by the elderly in Alberta since the introduction of a universal single payer health care insurance system in 1970. The study period coincides with the implementation of publicly-financed comprehensive medical and hospital insurance programmes for all Alberta residents, making it possible to perform historical and population-based utilization analyses. Thus the data used for the study included all hospital discharge abstracts generated by all Alberta hospitals from 1971 to 1991. Trends in hospital service utilization by the elderly in terms of total number of separations, patient-days, and per case measures such as average length of stay as well as per capita utilization rates were reviewed to identify utilization patterns over the study period. Further, relative per capita utilization measures, in comparison with the base year (1971), age group 15-44, male, metropolitan residents, were derived and historical trends identified. A series of regression analyses were carried out to estimate the effects of age, sex and origin on utilization rates. In addition, for the period of 1984-1991, Diagnosis Related Groups (DRG) case weights were used to measure per capita and per case rates and to analyse historical relative utilization rates over the 8-year period. In general, there has been a significant decline in hospital utilization by Albertans under the publicly-financed single payer system, but utilization rates for elderly have remained high, resulting in high relative utilization rates in comparison with other age groups. It was also noted that per capita utilization rates for rural residents were substantially higher than urban residents. It appears that these higher utilization rates by the elderly and rural residents in combination with tight bed and financial control by the government have been causing significant bed shortage problems for non-elderly elective patients in urban areas.}, author = {Bay, K. S. and Long, M. J. and Kerr, Ross J. C.}, citeulike-article-id = {1129877}, journal = {Health Serv Manage Res}, keywords = {activities, adolescent, adult, age, aged, agedstatistics, albertaepidemiology, analysis, and, atlas, bed, child, commission, comparative, data, demography, diagnosis-related, distribution, female, for, groups, health, hospital, hospitalsstatistics, humans, infant, length, male, newborn, numerical, occupancy, of, on, planning, preschool, professional, regression, review, services, single-payer, states, statistics, stay, study, system, the, united, utilization}, month = {Feb}, number = {1}, pages = {42--57}, posted-at = {2007-02-28 15:53:21}, priority = {2}, title = {Utilization of hospital services by the elderly: geriatric crisis in one Canadian single payer system}, volume = {10}, year = {1997} }

TY - JOUR ID - Bay1997 L3 - citeulike-article-id:1129877 N2 - As the number and proportion of elderly persons in the Canadian population increase, utilization of health services by the elderly becomes a growing concern for health service insurers, financial managers and policy makers, as well as for care providers. The purpose of this paper is to present the results of a study to analyse the use of hospital services by the elderly in Alberta since the introduction of a universal single payer health care insurance system in 1970. The study period coincides with the implementation of publicly-financed comprehensive medical and hospital insurance programmes for all Alberta residents, making it possible to perform historical and population-based utilization analyses. Thus the data used for the study included all hospital discharge abstracts generated by all Alberta hospitals from 1971 to 1991. Trends in hospital service utilization by the elderly in terms of total number of separations, patient-days, and per case measures such as average length of stay as well as per capita utilization rates were reviewed to identify utilization patterns over the study period. Further, relative per capita utilization measures, in comparison with the base year (1971), age group 15-44, male, metropolitan residents, were derived and historical trends identified. A series of regression analyses were carried out to estimate the effects of age, sex and origin on utilization rates. In addition, for the period of 1984-1991, Diagnosis Related Groups (DRG) case weights were used to measure per capita and per case rates and to analyse historical relative utilization rates over the 8-year period. In general, there has been a significant decline in hospital utilization by Albertans under the publicly-financed single payer system, but utilization rates for elderly have remained high, resulting in high relative utilization rates in comparison with other age groups. It was also noted that per capita utilization rates for rural residents were substantially higher than urban residents. It appears that these higher utilization rates by the elderly and rural residents in combination with tight bed and financial control by the government have been causing significant bed shortage problems for non-elderly elective patients in urban areas. IS - 1 JF - Health Serv Manage Res EP - 57 TI - Utilization of hospital services by the elderly: geriatric crisis in one Canadian single payer system VL - 10 SP - 42 KW - activities KW - adolescent KW - adult KW - age KW - aged KW - agedstatistics KW - albertaepidemiology KW - analysis KW - and KW - atlas KW - bed KW - child KW - commission KW - comparative KW - data KW - demography KW - diagnosis-related KW - distribution KW - female KW - for KW - groups KW - health KW - hospital KW - hospitalsstatistics KW - humans KW - infant KW - length KW - male KW - newborn KW - numerical KW - occupancy KW - of KW - on KW - planning KW - preschool KW - professional KW - regression KW - review KW - services KW - single-payer KW - states KW - statistics KW - stay KW - study KW - system KW - the KW - united KW - utilization AU - Bay, KS AU - Long, MJ AU - Kerr, Ross PY - 1997/Feb// ER -