Hospital overcrowding has plagued Winnipeg and other Canadian cities for years. This study explored factors related to overcrowding. Hospital files were used to examine patterns of hospital use from fiscal years 1996/1997 to 1999/2000. Chart reviews were conducted to examine appropriateness of admissions and hospital stays during one pressure week. Results indicate that pressure periods in the hospital system were driven by an influx of older adults with influenza-associated respiratory illnesses. Moreover, examination of one specific pressure week showed that at least 100 beds were occupied by patients who likely did not require acute care. The chart review revealed that a substantial proportion of non-acute patient-days were spent awaiting home care, long-term care, or diagnostic testing services. These findings suggest future bed pressures might be prevented through influenza vaccination and an increase in the availability of – and timely transfer to – alternative levels of care.

Being able to anticipate future needs for health services presents a challenge for health planners. Using existing population projections, two models are presented to estimate the demand for hospital beds in regions of Manitoba in 2020. The first, a current-use projection model, simply projects the average use for a recent three-year period into the future. The second, a 10-year trend analysis, uses Poisson regression to project future demand. The current-use projection suggests a substantial increase in the demand for hospital beds, while the trend analysis projects a decline. The last projections are consistent with ongoing increases in rates of day surgeries and declines in lengths of stay. The current-use projections need to be considered in the context of relatively low occupancy rates in rural hospitals and previous research on appropriateness of stays in acute care hospitals. If measures are taken to ensure more appropriate use of acute care hospital beds in the future, then the current-use projections of bed shortages are not a cause for concern.

This book by Barry McPherson is the fourth edition of Canada's first textbook on aging. Aging as a Social Process is a comprehensive text that elucidates and links the physiological, psychological, and social domains of aging within the context of what are known as individual and population aging. As the title implies, the book focuses primarily on the social processes of aging embedded in the micro-, meso-, and macro-level environments. It therefore balances individual-level experiences and social-structural forces connected to the causes and consequences of aging. It has been updated and expanded to reflect the increasing diversity in aging and the aged and the concomitant growth in research. This is captured through the integration of theory, research, and policy, from multiple perspectives and methodologies, applied to a wider range of substantive issues than in previous editions of the text. For instance, Aboriginal people and aging, homelessness, dating and sexuality, gay and lesbian relationships, end-of-life care, home care, and older drivers are but a few of the topics added or significantly supplemented in this new edition. In particular, I found the inclusion of a chapter dealing with individual and population health a needed and welcome addition. A life-course perspective on these topics that embraces the multiplicity of experience as individuals move through life stages, exposed to different historical and cultural contexts and facing and creating different life choices and chances, connects the material presented in this text.

A team of health researchers of the Manitoba Centre for Health Policy at the University of Manitoba was asked to forecast the number of acute care hospital beds that will be required to meet the needs of residents of the province of Manitoba by the year 2020. Methodological considerations for this request included identification of factors expected to affect bed use in the future, and how to account for these factors. The objective of this paper is to describe these methodological considerations, how decisions were made, and steps taken in our approach to this problem. The actual projections and their implications are the subject of another contribution in this issue of the journal (Finlayson, Stewart, Tate, MacWilliam & Roos, 2005).

This review evaluates the quality of available administrative data in the Canadian provinces, emphasizing the information needed to create integrated systems. We explicitly compare approaches to quality measurement, indicating where record linkage can and cannot substitute for more expensive record re-abstraction. Forty-nine original studies evaluating Canadian administrative data (registries, hospital abstracts, physician claims, and prescription drugs) are summarized in a structured manner. Registries, hospital abstracts, and physician files appear to be generally of satisfactory quality, though much work remains to be done. Data quality did not vary systematically among provinces. Primary data collection to check place of residence and longitudinal follow-up in provincial registries is needed. Promising initial checks of pharmaceutical data should be expanded. Because record linkage studies were “conservative” in reporting reliability, the reduction of time-consuming record re-abstraction appears feasible in many cases. Finally, expanding the scope of administrative data to study health, as well as health care, seems possible for some chronic conditions. The research potential of the information-rich environments being created highlights the importance of data quality.