Study identifies gaps in primary health care for seniors with multiple
OTTAWA, Jan. 27 /CNW/ -The number of health care services seniors use is
determined more by the number of chronic conditions they have than by
their age, according to a new study from the Canadian Institute for Health Information (CIHI). The study found that older seniors (85 and older) with no
chronic conditions made less than half the number of health care visits
as younger seniors (65 to 74) with three or more chronic conditions,
such as diabetes, hypertension and heart disease.
CIHI's study Seniors and the Health Care System: What Is the Impact of Multiple
Chronic Conditions? examines how seniors not living in institutions access health services
and what kind of care they receive. According to the study, three out
of four Canadians age 65 and older reported having at least one chronic
condition, while one in four seniors reported having three or more.
Among the study's key findings:
The 24% of seniors who reported living with three or more chronic
conditions were responsible for 40% of health care use among Canadian
Seniors with three or more chronic conditions reported using three times
as many health care services as Canadians age 65 and older with no
chronic conditions. Those with three or more chronic conditions also
reported more than twice the rate of visits to a family doctor as
seniors with only one chronic condition.
Similar patterns of health care use existed among adults age 45 to 64;
those with three or more chronic conditions made six times as many
health care visits as those with no reported conditions.
Seniors with three or more chronic conditions made three times as many
visits to emergency departments as seniors with no reported chronic
"Our study shows that the presence of chronic conditions has a much
higher impact on our health care resources than age alone. And with
rates of diabetes and hypertension on the rise in Canada, the
prevalence and resulting economic burden of these conditions is
expected to increase as the population ages," explains Jeremy Veillard,
Vice President of Research and Analysis at CIHI. "However, while the
risk of developing chronic conditions increases with age, good primary
care plays a strong role in managing them and even possibly delaying or
preventing their onset."
CIHI's study findings are based on the 2008 Canadian Survey of
Experiences With Primary Health Care, conducted by Statistics Canada
and funded by CIHI and the Health Council of Canada, which surveyed
adults not living in institutions or remote areas. The 11 common
chronic conditions included in the study are arthritis, asthma, cancer,
chronic pain, depression, diabetes, emphysema or chronic obstructive
pulmonary disease, heart disease, high blood pressure, mood disorders
other than depression and stroke.
The study found that Canadian seniors with three or more chronic
conditions reported taking an average of six prescription drugs
regularly, twice as many as seniors with only one chronic condition.
Seniors with chronic conditions regularly taking at least five
prescription medications were more than twice as likely to experience a
side effect requiring medical attention (13%) as those taking only one
or two prescription medications (6%). Yet less than half of seniors
with chronic conditions reported that their doctor reviewed their
medications (48%) and explained potential side effects (47%) at least
some of the time.
"Seniors who are taking a large number of drugs face not only the risk
of side effects from negative drug interactions but also the
possibility of not taking their medications as directed," says Dr. Bill
Hogg, Research Director of the C. T. Lamont Primary Healthcare Research
Centre at the Élisabeth Bruyère Research Institute at the University of
Ottawa. "Strategies to reduce the number of medications a senior is
prescribed, when possible, can result in better compliance with
medication regimens and lead to a better quality of life."
Reducing gaps in preventive care could lead to fewer health care visits
While the majority of seniors reported having a family physician, only
two out of five (42%) reported that at least some time in the past year
they had talked with a health professional about what they could do to
improve their health or prevent illness (including quitting smoking,
increasing exercise or limiting alcohol consumption). The results were
similar for tomorrow's seniors, as only 45% of adults between the age
of 45 and 64 spoke with their health care provider about things they
could do to improve their health.
"As Canada's population ages, it is natural to assume that the
prevalence of chronic conditions will increase," says Greg Webster,
CIHI's Director of Primary Health Care. "Efforts to better understand
the relationship between the management of chronic conditions and
health care use can lead to better preventive care, which will result
in healthier seniors and reduced costs to the system."
The report and the following figures and table are available from CIHI's
website, at www.cihi.ca.
Percentage of Seniors Who Reported Having 1 or More of 11 Chronic
Conditions, for Canada and by Province (Age-Sex Standardized) (Figure 1
in the report)
Percentage of Adults Who Reported Having at Least 1 of 11 Chronic
Conditions, by Age Group, Canada (Crude Estimates) (Figure 3 in the
Percentage of Seniors Who Reported 1 or More of 11 Select Chronic
Conditions Who Also Reported Experiencing a Side Effect From a
Prescription Medication That Required a Visit to a Medical Doctor in
the Past 12 Months, by Number of Prescribed Medications, Canada (Crude
Estimates) (Figure 6 in the report)
Rates of Health Care Visits in the Past 12 Months, by Number of Chronic
Conditions (Crude Estimates) (Table 1 in the report)
SOURCE CANADIAN INSTITUTE FOR HEALTH INFORMATION
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