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Trends in use of medical services by the elderly in British Columbia
M L Barer1, I R Pulcins, R G Evans
1Division of Health Services Research and Development, University of British Columbia, Vancouver.
Insights
Physician fee-for-service use in British Columbia increased 5.3% annually from 1974-1986. The primary driver was a 3% yearly rise in age-specific per capita use, especially among seniors accessing specialist care.
Area of Science:
- Health Economics
- Geriatric Medicine
- Healthcare Utilization
Background:
- Physician fee-for-service (FFS) is a common healthcare payment model.
- Understanding trends in healthcare utilization is crucial for policy planning.
- Previous research has not fully detailed FFS use patterns among the elderly in British Columbia.
Purpose of the Study:
- To analyze trends in physician fee-for-service utilization in British Columbia between 1974-75 and 1985-86.
- To identify factors contributing to the observed changes in FFS use, including population demographics and age-specific utilization rates.
- To investigate patterns of specialist care use among the elderly population.
Main Methods:
- Retrospective analysis of physician fee-for-service claims data from British Columbia.
- Calculation of annual percentage increases in overall FFS use.
- Decomposition of FFS use changes into population effects (age structure and growth) and age-specific per capita use increases.
- Focus on utilization trends for individuals aged 75 years and older.
Main Results:
- Overall physician FFS use increased by 5.3% annually during the study period.
- Population effects accounted for 2.2% annual increase (0.4% age structure, 1.8% population growth).
- Age-specific per capita use increased by 3% annually, with a 5.5% annual increase for those aged 75+.
- Elderly use of specialist care, particularly diagnostic services, saw the fastest growth, with the number of specialists seen by those 75+ doubling.
Conclusions:
- Increased per capita utilization among the elderly, independent of population aging, is a significant driver of FFS growth.
- Future healthcare policy should prioritize understanding and addressing the factors behind this rise in elderly healthcare consumption.
- Further research is necessary to elucidate the underlying dynamics driving the dramatic increase in healthcare use among seniors.
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.