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Age Differences in the Rates and Costs of Medical Procedures and Hospitalization during the Last Year of Life

Published online by Cambridge University Press:  29 November 2010

Marie Demers
Marie Demers
Affiliation:
Régie de l'Assurance-Maladie du Québec
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Abstract

The aim of this study was to investigate the age differences in the rates and costs of broad categories of medical procedures (diagnostic, therapeutic and surgical) during the last year of life as well as hospitalization among the adult population of Quebec. The study is population-based and took into account 90 per cent of deaths occurring among the Quebec population (15 years and older) in 1991. The data were collected from the physician claim files of the Health Insurance Board. Costs were defined as physician payments for the procedures performed. The results showed that the rates of these procedures increase with age to reach a maximum in middle life and then decrease among the elderly. A similar trend was observed in the average cost of surgery and diagnostic procedures but the average cost of therapeutic procedures followed a constant decline with age. These data suggest that the oldest old do not seem to get more aggressive care at the end of life than younger decedents.

Résumé

Cette étude examine les variations associées à l'âge dans la fréquence et le coût moyen des services diagnostiques, thérapeutiques et chirurgicaux dispensés durant la derniàre année de vie parmi la population adulte du Québec. Elle documente aussi l'hospitalisation durant la derniàre année de vie. Elle est basée sur 90 pour cent des décàs survenus au Québec en 1991 dans la population âgée de 15 ans ou plus. L'information provient des fichiers administratifs de la Régie de l'assurance-maladie, soit plus spécifiquement des demandes de paiement des médecins rémunérés à l'acte. Les coûts considérés sont les montants payés aux médecins pour les interventions réalisées. En ce qui a trait au taux d'utilisation de ces catégories de service, les résultats indiquent d'abord une augmentation avec l'âge atteignant un maximum parmi les adultes d'âge moyen et diminuant ensuite chez les personnes âgées. Une tendance similaire est observée pour le coût moyen de chirurgie et d'actes diagnostiques par usager. Pour sa part, le coût moyen des interventions thérapeutiques par usager est plus élevé chez les jeunes et subit une diminution constante avec l'âge. Ces données suggàrent que les personnes tràs âgées ne semblent pas plus soumises à des traitements intensifs au cours de la derniàre année de vie que les groupes d'âge plus jeunes.

Keywords

ElderlyHealth Care CostsDeathMedical ProceduresPhysician Services.Aîné(e)scoûts des soins médicauxdécàsinterventions médicalesservices médicaux.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 17 , Issue 2 , Été/Summer 1998 , pp. 186 - 196
Copyright
Copyright © Canadian Association on Gerontology 1998

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