Hospital admission before and after Medicare in Quebec

A 1 in 60 random sample of Quebec hospital admission records ("separations") for the years 1966 through 1974 was studied for evidence of change associated with the introduction in 1970 of universal health insurance. Non-surgical separation rates continued to decline in Montreal and remained steady in the rest of the province. In contrast, separations following surgical operation did not decline in Montreal and have increased substantially since 1970 in the rest of the province. Ten operative procedures accounting for 41 per cent of all surgical admissions were selected for separate study: of these, cholecystectomy, hysterectomy and hernia repairs conformed most closely to the new pattern. Directly or indirectly, Medicare may have contributed to these changes but more study is required to confirm or explain this.