Hospital downsizing and trends in health care use among elderly people in British Columbia

Research

Related Publications

Suter E, Misfeldt R, Mallinson S, Wilhelm A, Boakye O, Marchildon G, et al. Comparative Review of the Policy Landscape of Team-based Primary Health Care Service Delivery in Western Canada. Alberta Health Services; 2014.
Laberge M, Pang J, Walker K, Wong ST, Hogg W, Wodchis WP. QUALICOPC (Quality and Costs of Primary Care) Canada: A focus on the aspects of primary care most highly rated by current patients of primary care practices. Ottawa, ON: Canadian Foundation for Healthcare Improvement; 2014.
McGregor MJ, Abu-Laban RB, Ronald L, McGrail KM, Andrusiek D, Baumbusch J, et al. Nursing Home Characteristics Associated with Resident Transfers to Emergency Department. Canadian Journal on Aging. 2012;33(1):38-48.
Koehoorn M, McLeod CB, Fan JK, McGrail KM, Barer ML, Cote P, et al. Do private clinics or expedited fees improve wait- or return-to-work times for injured workers following knee surgery? Healthcare Policy. 2011;5(3):17-26.
Sutherland JM, Barer ML, Evans RG, Crump RT. Will paying the piper change the tune? Healthcare Policy. 2011;6(4):16-24.

Publication Topics

Hospital downsizing and trends in health care use among elderly people in British Columbia

Title
Publication TypeJournal Article
Year of Publication2000
AuthorsSheps SB, Reid RJ, Barer ML, Krueger H, McGrail KM, Green B, Evans RG, Hertzman C
JournalCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienneCMAJ
Volume163
Issue4
Pages397 - 401
Date Published2000
KeywordsAged, Aged, 80 and over, British Columbia, Cohort Studies, Female, Health Services for the Aged/utilization, Hospital Restructuring, Humans, Male
AbstractBACKGROUND: There has been considerable downsizing of acute care services in British Columbia over the past 2 decades. In this population-based study we examined changes in the proportion of elderly people who used acute care, long-term care and home care services between 1986-1988 and 1993-1995 to explore whether the downsizing has influenced use. Changes in death rates were also examined. METHODS: The British Columbia Linked Health Database was used to select all British Columbia residents aged 65 years, 75-76 years, 85-87 years or 90-93 years as of Jan. 1, 1986 (cohort 1), and Jan. 1, 1993 (cohort 2). Each person was assigned to 1 of 6 mutually exclusive categories of health care use reflecting different intensities of use (i.e., hospital, long-term or home care). The proportions of people within each category were compared between the 2 periods, as were the age-standardized death rates. RESULTS: There were 79,175 people in cohort 1 and 92,320 in cohort 2. Overall, the relative proportion of people in each use category was similar between the 2 study periods. The most substantial changes were an increase of 2 percentage points in the proportion of people who received no facility or home care services and a decrease of 2 to 3 percentage points in the proportion who received some acute care but no facility-based continuing care. The age-adjusted all-cause death rates for the earlier and later cohorts were virtually identical (15.7% and 15.8% respectively), although the rate increased from 63.6% to 70.1% among those in the "full-time facility with acute care" group. INTERPRETATION: Overall changes in health care use were small, which suggests that the repercussions of the decline in acute care services for elderly people have been minimal. The higher age-adjusted death rates in the later cohort in full-time care suggests that long-term stays are becoming reserved for a sicker group of elderly people than in the past.
Citation Key471