PMID- 10165373
OWN - NLM
STAT- MEDLINE
DCOM- 19970414
LR  - 20181130
IS  - 0951-4848 (Print)
IS  - 0951-4848 (Linking)
VI  - 10
IP  - 1
DP  - 1997 Feb
TI  - Utilization of hospital services by the elderly: geriatric crisis in one Canadian 
      single payer system.
PG  - 42-57
AB  - 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.
FAU - Bay, K S
AU  - Bay KS
AD  - Department of Public Health Sciences, University of Alberta, Canada.
FAU - Long, M J
AU  - Long MJ
FAU - Ross Kerr, J C
AU  - Ross Kerr JC
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Health Serv Manage Res
JT  - Health services management research
JID - 8811549
MH  - Adolescent
MH  - Adult
MH  - Age Distribution
MH  - Aged
MH  - Alberta/epidemiology
MH  - Bed Occupancy
MH  - Child
MH  - Child, Preschool
MH  - Commission on Professional and Hospital Activities
MH  - Demography
MH  - Diagnosis-Related Groups
MH  - Female
MH  - Health Planning
MH  - Health Services for the Aged/*statistics & numerical data
MH  - Hospitals/*statistics & numerical data
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Length of Stay
MH  - Male
MH  - Regression Analysis
MH  - *Single-Payer System
MH  - United States
MH  - Utilization Review/*statistics & numerical data
EDAT- 1997/01/07 00:00
MHDA- 1997/01/07 00:01
CRDT- 1997/01/07 00:00
PHST- 1997/01/07 00:00 [pubmed]
PHST- 1997/01/07 00:01 [medline]
PHST- 1997/01/07 00:00 [entrez]
AID - 10.1177/095148489701000106 [doi]
PST - ppublish
SO  - Health Serv Manage Res. 1997 Feb;10(1):42-57. doi: 10.1177/095148489701000106.