Abstract
We analysed physician fee-for-service use in British Columbia from 1974-75 to 1985-86. Over the study period use increased by 5.3% per year. This can be factored into increases attributable to changes in the age structure of the population (0.4% per year), general population growth (1.8%, for a combined annual "population effect" of 2.2%) and age-specific increases in per-capita use (3% per year). The average annual increase for people aged 75 years or more was 5.5% per capita. The area with the fastest growth in use by the elderly was specialist care, particularly diagnostic services. The average number of specialists seen by people aged 75 years or more doubled over the study period. Our results suggest that increased per-capita use among the elderly that is unrelated to aging of the population should be the main focus of future policy attention. Additional analyses are needed to determine the underlying dynamics of this dramatic increase in rates of use among the elderly.
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Selected References
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- Barer M. L., Evans R. G., Hertzman C., Lomas J. Aging and health care utilization: new evidence on old fallacies. Soc Sci Med. 1987;24(10):851–862. doi: 10.1016/0277-9536(87)90186-9. [DOI] [PubMed] [Google Scholar]
- Barer M. L., Evans R. G., Labelle R. J. Fee controls as cost control: tales from the frozen North. Milbank Q. 1988;66(1):1–64. [PubMed] [Google Scholar]
- Barer M. L. Regulating physician supply: the evolution of British Columbia's Bill 41. J Health Polit Policy Law. 1988 Spring;13(1):1–25. doi: 10.1215/03616878-13-1-1. [DOI] [PubMed] [Google Scholar]
- Contandriopoulos A. P. Cost containment through payment mechanisms: the Quebec experience. J Public Health Policy. 1986 Summer;7(2):224–238. [PubMed] [Google Scholar]
- Palmore E. B. Trends in the health of the aged. Gerontologist. 1986 Jun;26(3):298–302. doi: 10.1093/geront/26.3.298. [DOI] [PubMed] [Google Scholar]
- Schwartz W. B., Sloan F. A., Mendelson D. N. Why there will be little or no physician surplus between now and the year 2000. N Engl J Med. 1988 Apr 7;318(14):892–897. doi: 10.1056/NEJM198804073181405. [DOI] [PubMed] [Google Scholar]
- Verbrugge L. M. Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Mem Fund Q Health Soc. 1984 Summer;62(3):475–519. [PubMed] [Google Scholar]