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Medical Services Utilization Patterns by Seniors

Published online by Cambridge University Press:  29 November 2010

Mark W. Rosenberg  and
Amanda M. James
Mark W. Rosenberg
Affiliation:
Queen's University
Amanda M. James
Affiliation:
Simon Fraser University
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Abstract

The goal of this literature review is to identify key issues in the patterns of medical care utilization of services for seniors as a contribution to the National Consensus process on designing and delivering health care reforms which foster seniors' independence (Shapiro & Havens, 2000). A search strategy used to identify the relevant literature since 1985 focussing mainly on peer-reviewed journal articles is described and the results of the search strategy are summarized. Key articles are identified, analysed and synthesized based on Canadian and American evidence covering patterns of institutional care, physician use, ambulatory care and the determinants of utilization of these services.

Résumé

Cette analyse documentaire vise à déterminer les principaux éléments du mode d'utilisation des soins médicaux chez les aînés dans le cadre du Consensus national sur la conception et la prestation d'une réforme des soins de santé visant à promouvoir l'autonomie des personnes âgées (Shapiro & Havens, 2000). On y présente une stratégie de recherche de la documentation pertinente depuis 1985 portant principalement sur des articles de revuses révisés par les pairs et on résume les conclusions de la recherche. On souligne les principaux articles, lesquels sont analysés et synthétisés à partir de modalités américaines ou canadiennes de fonctionnement institutionnel, de recours aux médecins, aux soin ambulatoires et sur des déterminants de l'utilisation de ces services.

Keywords

SeniorsMedical ServicesUtilizationCanadaUnited StatesAîné(e)sservices médicauxutilisationCanadaÉtats-Unis
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , Issue S1 , Summer/Été 2000 , pp. 125 - 142
Copyright
Copyright © Canadian Association on Gerontology 2000

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References

Alemayehu, E., Molloy, D.W., Guyatt, G.H., Singer, J., Penington, G., Basile, J., Eisemann, M., Finucane, P., McMurdo, M.E., & Powell, C. et al. (1991). Variability in physicians' decisions on caring for chronically ill elderly patients: An international study. Canadian Medical Association Journal, 144(9), 1133–1138.Google ScholarPubMed
Alexander, T. (1990). The elderly in acute care: A literature review. Dimensions in Health Service, 67(5), 27–33.Google ScholarPubMed
Anderson, G.M. (1997). Hospital restructuring and the epidemiology of hospital utilization: Recent experience in Ontario. Medical Care, 35(10 suppl.), OS93–OS101.CrossRefGoogle ScholarPubMed
Anderson, G.M., Pulcins, I.R., Barer, M.L., Evans, R.G., & Hertzman, C. (1990). Acute care hospital utilization under Canadian national health insurance: The British Columbia experience from 1969 to 1988. Inquiry, 27(4), 352–358.Google ScholarPubMed
Anderson, R., & Neman, J. (1973). Societal and individual determinants of medical care utilization. Milbank Memorial Fund Quarterly, 51, 95–124.CrossRefGoogle Scholar
Arber, S., & Ginn, J. (1991). Gender and later life. Newbury Park, CA: Sage Publications.Google Scholar
Barer, M.L., Evans, R.G., & Hertzman, C. (1995). Avalanche or glacier? Health care and the demographic rhetoric. Canadian Journal on Aging, 14(2), 193–224.CrossRefGoogle Scholar
Barer, M.L., Evans, R.G., Hertzman, C., & Lomas, J. (1987). Aging and health care utilization. New evidence on old fallacies. Social Science and Medicine, 24(10), 851–862.CrossRefGoogle ScholarPubMed
Barer, M.L., Pulchins, I.R., Evans, R.G., Hertzman, C., Lomas, J., &. Anderson, G.M. (1989). Trends in the use of medical services by the elderly in British Columbia. Canadian Medical Association Journal, 141, 39–45.Google ScholarPubMed
Bazargan, M., Bazargan, S., & Baker, R.S. (1998). Emergency department utilization, hospital admissions and physician visits among elderly African American persons. The Gerontologist, 38(1), 25–35.CrossRefGoogle ScholarPubMed
Béland, F., Lemay, A., Philibert, L., Maheux, B., & Gravel, G. (1991). Elderly patients' use of hospital-based emergency services. Medical Care, 29(5), 408–418.CrossRefGoogle ScholarPubMed
Belgrave, L.L., Wykle, M.L., & Cho, J.M. (1993). Health, double jeopardy, and culture: The use of institutionalization by African-Americans. Gerontologist, 33(3) 379–385.CrossRefGoogle ScholarPubMed
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(2), 225–244.CrossRefGoogle Scholar
Blazer, D.G., Landerman, L.R., Fillenbaum, G., & Horner, R. (1995) Health services access and use among older adults in North Carolina: Urban vs rural residents. American Journal of Public Health, 85(10), 1384–1390.CrossRefGoogle Scholar
Brotman, S.L., & Yaffe, M.J. (1994). Are physicians meeting the needs of family caregivers of the frail elderly? Canadian Family Physician, 40, 679–685.Google ScholarPubMed
Chappell, N.L., & Lai, D. (1998) Health care service use by Chinese seniors in British Columbia, Canada. Journal of Cross-Cultural Gerontology, 13, 21–37.CrossRefGoogle ScholarPubMed
Cox, C. (1986). Physician utilization by three groups of ethnic elderly. Medical Care, 24(8), 667–676.CrossRefGoogle ScholarPubMed
DeCoster, C., Roos, N.P., Carriere, K.C., & Peterson, S. (1997). Inappropriate hospital use. Canadian Medical Association Journal, 157(7), 889–896.Google ScholarPubMed
Demers, M. (1996). Factors explaining the increase in cost for physician care in Quebec's elderly population. Canadian Medical Association Journal, 155(11), 1555–1560.Google ScholarPubMed
Driedger, L., & Chappell, N.L. (1987). Aging and ethnicity: Towards an interface. Toronto: Butterworth.Google Scholar
Evans, R.G., Barer, M.L., Hertzman, C., Anderson, G.M., Pulcins, I.R., & Lomas, J. (1989). The long good-bye: The great transformation of the British Columbia hospital system. Health Services Research, 24(4), 435–459.Google Scholar
Evashwick, C., Rowe, G., Diehr, P., & Branch, L. (1984). Factors explaining the use of health care services by the elderly. Health Services Research, 19(3), 357–382.Google ScholarPubMed
Eyles, J., Birch, S., & Newbold, K.B. (1995). Delivering the goods? Access to family physician services in Canada: A comparison of 1985 and 1991. Journal of Health & Social Behaviour, 36(4), 322–332.CrossRefGoogle Scholar
Gillanders, W.R., & Buss, T.F. (1993). Access to medical care among the elderly in rural Northeastern Ohio. Journal of Family Practice, 37(4), 349–355.Google ScholarPubMed
Hertzman, C., Pulcins, I.R., Barer, M.L., Evans, R.G., Anderson, G.M., & Lomas J. (1990). Flat on your back or back to your flat? Sources of increased hospital services utilization among the elderly in British Columbia. Social Science and Medicine, 30(7), 819–828.CrossRefGoogle ScholarPubMed
James, A.M. (1999). Closing rural hospitals in Saskatchewan: On the road to wellness? Social Science and Medicine, 49(8), 1021–1034.CrossRefGoogle Scholar
Johansen, H., Nair, C., & Bond, J. (1994). Who goes to the hospital? An investigation of high users of hospital days. Health Reports, 6(2), 253–277.Google Scholar
Lagoe, R.J., Bice, S.E., & Abulencia, P.B. (1987). Ambulatory surgery utilization by age level. American Journal of Public Health, 77(1), 33–37.CrossRefGoogle ScholarPubMed
Masi, R., Mensah, L., & McLeod, K.A. (1993). Health and cultures. Oakville, ON: Mosaic Press.Google Scholar
Moore, E.G., & Rosenberg, M.W., with McGuinness, D. (1997). Growing old in Canada: Demographic and geographic perspectives. Ottawa and Toronto: Statistics Canada and ITP Nelson.Google Scholar
Morris, R.D., & Munasinghe, R.L. (1994). Geographic variability in hospital admission rates for respiratory disease among the elderly in the United States. Chest, 106(4), 1172–1181.CrossRefGoogle ScholarPubMed
Murphy, J.F., & Hepworth, J.T. (1996). Age and gender differences in health services utilization. Research in Nursing & Health, 19(4), 323–329.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Parboosingh, E.J., & Larsen, D.E. (1987). Factors influencing frequency and appropriateness of utilization of the emergency room by the elderly. Medical Care, 25(12), 1139–1144.CrossRefGoogle ScholarPubMed
Penning, M.J., & Keating, N.C. (2000). Self-, informal and formal care: Partnerships in community-based and residential long-term care settings. Canadian Journal on Aging, 19(suppl. 1), 75–100.CrossRefGoogle Scholar
Petcher, M.K., & Milligan, S.E. (1988). Access to health care in a black urban elderly population. The Gerontologist, 28(2), 213–217.CrossRefGoogle Scholar
Randhawa, J., & Riley, R. (1995). Trends in hospital utilization, 1982–1983 to 1992–1993. Health Report, 7(1), 41–537.Google Scholar
Roos, N.P. (1989). Predicting hospital utilization by the elderly. The importance of patient, physician, and hospital characteristics. Medical Care, 27(10), 905–919.CrossRefGoogle ScholarPubMed
Roos, N.P. (1992). Hospitalization style of physicians in Manitoba: The disturbing lack of logic in medical practice. Health Services Research, 27(3), 361–384.Google ScholarPubMed
Rosenberg, M.W., & Hanlon, N.T. (1996). Access and utilization: A continuum of health service environments. Social Science and Medicine, 43(6), 973–983.CrossRefGoogle ScholarPubMed
Rosenberg, M.W., & James, A. (1994). The end of the second most expensive health care system in the world: Some geographical implications. Social Science and Medicine, 39(7), 967–981.CrossRefGoogle ScholarPubMed
Rosenberg, M. W., & Moore, E.G. (1997). The health of Canada's elderly population: Current status and future implications. Canadian Medical Association Journal, 157(8), 1025–1032.Google ScholarPubMed
Roush, R.E., Teasdale, T.A., Murphy, J.N., & Kirk, M.S. (1995). Impact of a personal emergency response system on hospital utilization by community-residing elders. Southern Medical Journal, 88(9), 917–922.CrossRefGoogle ScholarPubMed
Saldov, M., & Chow, P. (1994). The ethnic elderly in Metro Toronto hospitals, nursing homes, and homes for the aged: Communication and health care. International Journal of Aging & Human Development, 38(2), 117–135.CrossRefGoogle ScholarPubMed
Shapiro, E., & Havens, B. (2000). Bridging the knowledge gap: From evidence to policy and practice that fosters seniors' independence. Canadian Journal on Aging, 19(suppl. 1), 179–193.CrossRefGoogle Scholar
Shapiro, E., & Tate, R.B. (1989). Is health care use changing? A comparison between physician, hospital, nursing-home, and home-care use of two elderly cohorts. Medical Care, 27(11), 1002–1014.CrossRefGoogle ScholarPubMed
Sullivan, P. (1989). Doctors guilty of “ageism and indifference”, MD tells General Council. Canadian Medical Association Journal, 141(7), 720, 725, 727.Google ScholarPubMed
Tataryn, D., Roos, N.P., & Black, C.D. (1995). Utilization of physician resources for ambulatory care. Medical Care, 33(12), DS84–DS99.CrossRefGoogle ScholarPubMed
Thomas, C., & Kelman, H.R. (1990). Health services use among the elderly under alternative health service delivery systems. Journal of Community Health, 15(2), 77–92.CrossRefGoogle ScholarPubMed
Thorson, J.A., & Powell, F.C. (1992). Rural and urban elderly construe health differently. Journal of Psychology, 126(3), 251–260.CrossRefGoogle Scholar
Wilkins, K., & Park, E. (1997). Characteristics of hospital users. Health Reports, 9(3), 27–36.Google ScholarPubMed
Wolinsky, F.D., Culler, S.D., Callahan, C.M., & Johnson, R.J. (1994). Hospital resource consumption among older adults: a prospective analysis of episodes, length of stay, and charges over a seven-year period. Journal of Gerontology, 49(5), S240–S252.CrossRefGoogle Scholar
Wolinsky, F.D., Stump, T.E., & Johnson, R.J. (1995). Hospital utilization profiles among older adults over time: Consistency and volume among survivors and decedents. Journals of Gerontology. Series B, Psychological Sciences & Social Sciences, 50(2), S88–S100.CrossRefGoogle ScholarPubMed