Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T04:48:37.073Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of Hospitals by Older versus Younger Canadians: Myths and Misconceptions

Published online by Cambridge University Press:  22 June 2018

Donna M. Wilson ,
Ye Shen  and
Gail Low
Donna M. Wilson*
Affiliation:
Faculty of Nursing, University of Alberta, Edmonton
Ye Shen
Affiliation:
School of Public Health, University of Alberta, Edmonton
Gail Low
Affiliation:
Faculty of Nursing, University of Alberta, Edmonton
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Donna M. Wilson, Ph.D., RN Professor, Faculty of Nursing Level 3, Edmonton Clinic Health Academy 11405-87 Avenue University of Alberta Edmonton, AB T6G 1C9 <[email protected]>
Get access Rights & Permissions [Opens in a new window]

Abstract

This study investigated concerns regarding the extensive use of hospitals by older people and subsequent long wait lists. We analysed complete individual-anonymous, 2014–2015 inpatient hospital data for all Canadian provinces and territories (except Quebec). People aged 65 and older accounted for 37.0 per cent of all hospital episodes and 41.5 per cent of all admissions to intensive or coronary care units. Similarly, of all admitted individuals, 32.8 per cent were older. The data also revealed only 14.3 per cent of older Canadians living outside of Quebec were admitted to hospital one or more times that year. This study indicates that issues other than hospital use by older people should be addressed in Canada for improved hospital accessibility. Improved care of older persons is also indicated, as their higher risk of hospital admission, longer hospital stays, and dying in hospital could be from a lack of age-informed hospital and community services.

Résumé

Afin de mieux répondre aux préoccupations concernant l’utilisation intensive des hôpitaux par les personnes âgées et l’augmentation subséquente des listes d’attente et de l’attente dans les services de santé hospitaliers au Canada, les données anonymes individuelles des patients hospitalisés en 2014-2015 dans toutes les provinces et territoires (sauf le Québec) ont été analysées. Les personnes de plus de 65 ans composaient 37 % de tous les épisodes de consultation hospitalière et 41,5 % des admissions en soins spéciaux (unités de soins intensifs ou coronariens). De tous les individus admis, 32,8 % étaient des personnes âgées. Les données montrent aussi que seulement 14,3 % des aînés canadiens vivant à l’extérieur du Québec ont été admis à l’hôpital une ou plusieurs fois cette année. Cette étude indique que des problématiques qui ne sont pas liées à l’utilisation des hôpitaux par les personnes âgées devraient être prises en compte en priorité au Canada pour améliorer l’accessibilité aux soins hospitaliers. L’amélioration des soins aux personnes âgées est aussi indiquée, considérant le risque plus élevé d’admission ou de mort à l’hôpital, et leurs séjours plus longs en milieu hospitalier, qui pourraient être expliqués par un manque de services hospitaliers et communautaires adaptés aux aînés.

Keywords

aginghospitalpopulation healthhospital utilizationageismCanadavieillissementhôpitalsanté populationnelleutilisation des hôpitauxâgismeCanada
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 3 , September 2018 , pp. 309 - 317
Copyright
Copyright © Canadian Association on Gerontology 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This research study was funded by a Law Commission of Ontario research grant. We appreciate Stephen Birch for his help in obtaining that grant. The authors declare no financial or ethical conflicts of interest.

References

Archibald, M. M., & Fraser, K. (2013). The potential for nurse practitioners in health care reform. Journal of Professional Nursing, 29(5), 270–275.CrossRefGoogle ScholarPubMed
Busby, J., Purdy, S., & Hollingworth, W. (2015). A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions. BMC Health Services Research, 15, 324.CrossRefGoogle ScholarPubMed
Butalia, S., Johnson, J. A., Ghali, W. A., & Rabi, D. M. (2013). Clinical and socio-demographic factors associated with diabetic ketoacidosis hospitalization in adults with type 1 diabetes. Diabetic Medicine, 30(5), 567–573.CrossRefGoogle ScholarPubMed
Canadian Hospice Palliative Care Association. (2014). Fact sheet: Hospice palliative care in Canada. Ottawa, ON: Author. Retrieved from http://www.chpca.net/media/330558/Fact_Sheet_HPC_in_Canada%20Spring%202014%20Final.pdfGoogle Scholar
Canadian Institute for Health Information. (2005). Hospital trends in Canada. Results of a project to create a historical series of statistical and financial data for Canadian hospitals over twenty-seven years. Ottawa, ON: Author. Retrieved from https://secure.cihi.ca/free_products/Hospital_Trends_in_Canada_e.pdfGoogle Scholar
Canadian Institute for Health Information. (2011). Health care in Canada, 2011: A focus on seniors and aging. Ottawa, ON: Author. Retrieved from https://secure.cihi.ca/free_products/HCIC_2011_seniors_report_en.pdfGoogle Scholar
Canadian Institute for Health Information. (2012a). Health care in Canada, 2012: A focus on wait times. Ottawa, ON: Author. Retrieved from https://www.cihi.ca/en/HCIC2012_CH4_EN.pdfGoogle Scholar
Canadian Institute for Health Information. (2012b). Waiting for specialized care trends to vary by the underlying clinical condition and ultimate discharge destination. Ottawa, ON: Author. Retrieved from https://www.cihi.ca/en/HCIC2012_CH4_EN.pdfGoogle Scholar
Canadian Medical Association. (2015). A policy framework to guide a National Seniors Strategy for Canada. Ottawa, ON: Author. Retrieved from http://www.caep.ca/sites/caep.ca/files/caep/files/final_policy_framework_eng_-_aug24.pdfGoogle Scholar
Canadian Medical Association. (2016). The state of seniors health care in Canada. Ottawa, ON: Author. Retrieved from https://www.cma.ca/En/Lists/Medias/the-state-of-seniors-health-care-in-canada-september-2016.pdfGoogle Scholar
Canadian Patient Safety Institute. (2016). Healthcare associated infections (HAI). Gloucester, ON: Author. Retrieved from http://www.patientsafetyinstitute.ca/en/Topic/Pages/Healthcare-Associated-Infections-(HAI).aspxGoogle Scholar
Carlisle, C. E., Mamdani, M., Schachar, R., & To, T. (2012). Aftercare, emergency department visits, and readmissions in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 51(3), 283–293.CrossRefGoogle Scholar
Chen, Y., Dales, R., & Krewski, D. (2001). Asthma and the risk of hospitalization in Canada: The role of socioeconomic and demographic factors. Chest, 119(3), 708–713.CrossRefGoogle ScholarPubMed
Clark, J. (2016). Health at a glance: Difficulty accessing health care services in Canada. Ottawa, ON: Statistics Canada. Retrieved from http://www.statcan.gc.ca/pub/82-624-x/2016001/article/14683-eng.htmGoogle Scholar
Costa, A. P., Poss, J. W., Peirce, T., & Hirdes, J. P. (2012). Acute care inpatients with long-term delayed-discharge: Evidence from a Canadian health region. BMC Health Services Research, 12, 172.CrossRefGoogle ScholarPubMed
De Coster, C., Bruce, S., & Kozyrski, A. (2005). Use of acute care hospitals by long-stay patients: Who, how much, and why? Canadian Journal on Aging, 24(Suppl. 1), 97–106.CrossRefGoogle Scholar
Evans, R., McGrail, K. M., Morgan, S. G., Barer, M. L., & Hoertzman, C. (2001). Apocalypse no: Population aging and the future of health care systems. Canadian Journal on Aging, 20(Supp. 1), 160–191.CrossRefGoogle Scholar
Gilca, R., Deceuninck, G., De Serres, G., Boulianne, N., Sauvageau, C., Quach, C., … Sknowronski, D. M. (2011). Effectiveness of pandemic H1N1 vaccine against influenza-related hospitalization in children. Pediatrics, 128(5), e1084–e1091.CrossRefGoogle ScholarPubMed
Government of Canada. (2017). Chapter 3 – A strong Canada at home and in the world. Ottawa, ON: Author. Retrieved from http://www.budget.gc.ca/2017/docs/plan/chap-03-en.htmlGoogle Scholar
Gruneir, A., Kwong, J. C., Campitelli, M. A., Newman, A., Anderson, G. M., Rochon, P. A., & Mor, M. (2014). Influenza and seasonal patterns of hospital use by older adults in long-term care and community settings in Ontario, Canada. American Journal of Public Health, 104(2), 3141–e147.CrossRefGoogle ScholarPubMed
Hebert, R. (2002). Research on aging: Providing evidence for rescuing the Canadian health care system. Canadian Journal on Aging, 21(3), 343–347.CrossRefGoogle Scholar
HelpAge International. (2015). Global AgeWatch Index 2015 insight report. Retrieved from http://www.helpage.org/global-agewatch/reports/global-agewatch-index-2015-insight-report-summary-and-methodology/Google Scholar
Johansen, H., & Finès, P. (2012). Acute care hospital days and mental diagnoses. Catalogue No. 82-003-X. Ottawa, ON: Statistics Canada. Retrieved from http://www.statcan.gc.ca/pub/82-003-x/2012004/article/11761-eng.pdfGoogle Scholar
Kamal, N., Lindsay, M. P., Cote, R., Fang, J., Kapral, M. K., & Hill, M. D. (2015). Ten-year trends in stroke admissions and outcomes in Canada. Canadian Journal of Neurological Sciences, 42(3), 168–175.CrossRefGoogle Scholar
Kelly, S., Sprague, A., Fell, D. B., Murphy, P., Aelicks, N., Guo, Y., … Walker, M. (2013). Examining caesarian section rates in Canada using the Robson Classification System. Canadian Journal of Obstetrics & Gynaecology, 35(3), 206–214.CrossRefGoogle ScholarPubMed
McIsaac, D. I., Yang, H., Sundaresan, S., Doering, P., Vanwani, S. G., Thavorn, K., & Forster, A. J. (2017). Association of delay of urgent or emergency surgery with mortality and use of health care resources: A propensity score-matched observational cohort study. Canadian Medical Association Journal, 189(27), E905–E917.CrossRefGoogle ScholarPubMed
McIvor, R. A., Boulet, L. P., FitzGerald, J. M., Zimmerman, S., & Chapman, K. R. (2007). Asthma control in Canada: No improvement since we last looked in 1999. Canadian Family Physician, 53(4), 672–677.Google ScholarPubMed
Menec, V. H., Bruce, S., & MacWilliam, L. (2005). Exploring reasons for bed pressures in Winnipeg acute care hospitals. Canadian Journal on Aging, 24(Suppl. 1), 121–131.CrossRefGoogle ScholarPubMed
Menec, V. H., Lix, L, Nowicki, S., & Ekuma, O. (2007). Health care use at the end of life among older adults: Does it vary by age? Journals of Gerontology Series A, 62(4), 400–407.CrossRefGoogle Scholar
Nasa, P., Juneja, D., & Singh, O. (2012). Severe sepsis and septic shock in the elderly: An overview. World Journal of Critical Medicine, 4(1), 23–30.Google Scholar
Ng, E., Sanmartin, C., Tu, J., & Manuel, D. (2015). Use of acute care hospital services by immigrant seniors in Ontario: A linkage study. Retrieved from http://www.statcan.gc.ca/pub/82-003-x/2014010/article/14099-eng.htmGoogle Scholar
Organisation for Economic Co-operation and Development. (2016). OECD health statistics 2014 – Frequently requested data: Hospital beds density per 1000 population. Paris, FRA: Author. Retrieved from http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequently-requested-data.htmGoogle Scholar
Public Health Agency of Canada. (2017a). Chronic disease facts and figures. Ottawa, ON: Author. Retrieved from http://www.phac-aspc.gc.ca/cd-mc/facts_figures-faits_chiffres-eng.phpGoogle Scholar
Public Health Agency of Canada. (2017b). How healthy are Canadians? A trend analysis of the health of Canadians from a healthy living and chronic disease perspective. Ottawa, ON: Author. Retrieved from https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/healthy-living/how-healthy-canadians/pub1-eng.pdfGoogle Scholar
Rowe, T. A., & Juthani-Mehta, M. (2013). Urinary tract infection in older adults. Aging Health, 9(5). doi: 10.2217/ahe.13.38CrossRefGoogle ScholarPubMed
Sangster-Gormley, E., Carter, N., Donald, F., Misener, R. M., Ploeg, J., Kaasalainen, S., … Wickson-Griffiths, A. (2013). A value-added benefit of nurse practitioners in long-term care settings: Increased nursing staff’s ability to care for residents. Nursing Leadership, 26(3), 24–37.CrossRefGoogle Scholar
Seow, H., Barbera, L., Pataky, R., Lawson, B., O’Leary, E., Fassbender, K., … Sutradhar, R. (2015). Does increasing home care nursing reduce emergency department visits at the end of life? Journal of Pain and Symptom Management, 51(2), 204–212.CrossRefGoogle ScholarPubMed
Seow, H., Sutradhar, R., McGrail, K., Fassbender, K., Pataky, R., Lawson, B., … Barbera, L. (2016). End-of-life cancer care: Temporal associations between homecare nursing and hospitalizations. Journal of Palliative Medicine, 19(3), 263–270.CrossRefGoogle ScholarPubMed
Statistics Canada. (2015). Age-specific mortality rates per 1000 population by age group and sex, Canada, provinces and territories, 2009. Ottawa, ON: Author. Retrieved from http://www.statcan.gc.ca/pub/91-209-x/2013001/article/11785/tbl/tbl02-eng.htmGoogle Scholar
Statistics Canada. (2016a). Population by year, by province and territory (Number). Ottawa, ON: Author. Retrieved from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/demo02a-eng.htmGoogle Scholar
Statistics Canada. (2016b). Research highlights on health and aging. Ottawa, ON: Author. Retrieved from http://www.statcan.gc.ca/pub/11-631-x/11-631-x2016001-eng.htmGoogle Scholar
Sutherland, J. M., & Crump, R. T. (2013). Alternative level of care: Canada’s hospital beds, the evidence and the options. Healthcare Policy, 9(1), 26–34.Google ScholarPubMed
Thomas, R. E., Wilson, D. M., Birch, S., & Woytowich, B. (2014). Examining end-of-life case management: Systematic review. Nursing Research and Practice, 2014(2014), Article ID 651681, 14 pages.CrossRefGoogle ScholarPubMed
Touchie, C. (2013). Report of the incidence and prevalence of diseases and other health-related issues in Canada. A study of the MCC blueprint project. Ottawa, ON: Medical Council of Canada. Retrieved from http://mcc.ca/wp-content/uploads/Touchie-Incidence-Prevalence-Report.pdfGoogle Scholar
Turcotte, M. (2015). Family caregiving: What are the consequences? Ottawa, ON: Statistics Canada. Retrieved from http://www.statcan.gc.ca/pub/75-006-x/2013001/article/11858-eng.htmGoogle Scholar
UNICEF. (2017). Place of delivery (DEC 2016). New York, NY: Author. Retrieved from https://data.unicef.org/topic/maternal-health/delivery-care/Google Scholar
United Nations Development Programme. (2016). Human development report 2016: Human development for everyone. New York, NY: Author. Retrieved from http://hdr.undp.org/sites/default/files/2016_human_development_report.pdfGoogle Scholar
Verma, J., Petersen, S, Samis, S., Akunov, N., & Graham, J. (2014). Healthcare priorities in Canada: A backgrounder. Ottawa, ON: Canadian Foundation for Healthcare Improvement. Retrieved from http://www.cfhi-fcass.ca/sf-docs/default-source/documents/harkness-healthcare-priorities-canada-backgrounder-e.pdfGoogle Scholar
Wait Time Alliance. (2015). Eliminating code gridlock in Canada’s health care system. 2015 Wait Time Alliance report card. Retrieved from http://www.waittimealliance.ca/wp-content/uploads/2015/12/EN-FINAL-2015-WTA-Report-Card_REV.pdfGoogle Scholar
Wilson, D. M., Brow, R., & Playfair, R. (2017). What is the “right” number of nursing home beds for population health needs? An indicator development project. The Journal of Nursing Home Research Science, 3, 16–21.Google Scholar
Wilson, D. M., Hewitt, J. A., Thomas, R., Mohankumar, D., & Kovacs Burns, K. (2011). Age-based differences in care setting transitions over the last year of life. Current Gerontology and Geriatrics Research, 2011, article ID 101276, 7 pages. http://dx.doi.org/10.1155/2011/101276CrossRefGoogle ScholarPubMed
Wilson, D. M., Shen, Y., & Birch, S. (2017). New evidence on end-of-life hospital utilization for enhanced health policy and services planning. Journal of Palliative Medicine, 20(7), 752–758.CrossRefGoogle ScholarPubMed
Wilson, D. M., Truman, C., Thomas, R., Fainsinger, R., Kovacs-Burns, K., & Justice, C. (2009). The rapidly changing location of death in Canada, 1994–2004. Social Science & Medicine, 68(10), 1752–1758. doi: 10.1016/j.socscimed.2009.03.006CrossRefGoogle Scholar
Wilson, D. M., Vihos, J., Hewitt, J. A., Barnes, N., Peterson, K., & Magnus, R. (2014). Examining waiting placement in hospital: Utilization and the lived experience. Global Journal of Health Science, 6(2), 12–22. doi: 10.5539/gjhs.v6n2p12Google Scholar
Wodchis, W. P., Williams, A. P., & Mery, G. (2014). Creating strategic change in Canadian healthcare. Conference white paper working drafts. Retrieved from https://smith.queensu.ca/centres/monieson/knowledge_articles/2014-WhitePaper-Wodchis.pdfGoogle Scholar