Costs of Ambulatory Medical Care Over the Long Term in the Quebec Medicare System

Sociology of Aging in Canada: Issues for the Millennium

This paper presents a selective review of sociological gerontology in Canada, examining where it has been, where it is, and where it could go in the future in four general areas: inequality, population aging and the social construction of crisis; family relations and caregiving; work, retirement and income security; and health, health care systems, and health policy. This review suggests that the sociology of aging has not differentiated itself by the topic studied or by its applied and empirical focus, but rather in its unique perspective that reveals the importance of social structures for the personal and private experience of aging. In doing so, sociological gerontology rejects deterministic assumptions ofinevitability. The importance of relating the personal to the public and of continuing a critical examination of existing trends will continue into the future. An additional challenge will be the generation ofnew knowledge on how to transform institutions so that they better enhance the quality oflife ofseniors, including the identification of support of family structures and community environments, as well as more appropriate health and income security policies. This also includes research on effective and appropriate means of introducing new structures and implementing new policies and programs within the context of current social institutions.

Do ethnic groups use health services like the majority of the population? A study from Quebec, Canada

The purpose of this study was to compare the use of medical services over a period of one year by members of ethnic groups and native Quebecers in Canada, while controlling for a number of confounding factors. The objective was to determine whether the two groups made the same number of medical visits to the same sites (private offices, outpatient clinic and emergency room and hospital inpatient care) and the same types of physicians (general practitioners, specialists). Two sources of data were used. The first was the Quebec Health Survey conducted in 1987 on a representative sample of 31,995 noninstitutionalized persons. Through personal interviews and self-administered questionnaires, data were collected on the demographic characteristics and health status of the respondents. The second source of data was the Quebec physician claims database, which contains a complete registry of services paid to physicians on a fee for service basis in the 12 months prior to the survey. The two databases were linked at the individual level (success rate is 88%). Members of ethnic groups aged 15 years and older were then individually matched to native Quebecers having the same six characteristics (age, gender, household income, access to health care facilities, perceived health and overall health). Final sample size was 1182 (divided equally into the two study groups). Results showed that neither the average number of medical services used over a year by the two groups nor the number of users differed. However, ethnic groups made more visits to specialists in private offices. Although not definite, possible explanations of these results are discussed. It is concluded that health care professionals should be sensitive to the particular needs of ethnic groups in order to provide them with accessible and appropriate services.

Socioeconomic differences in the use of physician services in Nova Scotia

OBJECTIVES

Socioeconomic differences in use of physician services in Nova Scotia, Canada were examined.

METHODS

The study was based on survey data, containing information on socioeconomic status, linked to physician claims data. Socioeconomic differences in use of physician services were estimated, adjusted for age, sex, and region of residence.

RESULTS

Large socioeconomic differences were observed in the use of physician services, with use inversely related to both household income and education. These differences remained after adjustment for age, sex, and region.

CONCLUSIONS

Use of physician services is inversely associated with socioeconomic status.

How different are users and non-users of alternative medicine?

PURPOSE

To determine whether users and non-users of alternative medicine in the province of Quebec differ in terms of demographic characteristics, health profile or utilization of medical services.

METHODS

The Quebec Health Insurance Board (QHIB) medical service records of the Quebec Health Survey (1987) respondents for the 12 months before the survey were linked with respondents' survey answers. Those who saw an alternative medicine practitioner at their last professional consultation (the "users", n = 169) were matched by diagnosis and area of residence with those who saw a physician instead (the "non-users", n = 169).

RESULTS

Users and non-users of alternative medicine differed in age, activity, education and income. After adjustment for age, education and income, the two groups had a similar health profile, but users of alternative medicine had made fewer medical visits in the previous year.

CONCLUSION

Alternative medicine attracts a particular clientele. More research is needed to understand the reasons people look to alternative therapies instead of conventional medicine.