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Growing Old Together: The Influence of Population and Workforce Aging on Supply and Use of Family Physicians

Published online by Cambridge University Press:  31 March 2010

Diane E. Watson ,
Robert Reid ,
Noralou Roos  and
Petra Heppner
Diane E. Watson*
Affiliation:
University of British Columbia
Robert Reid
Affiliation:
Group Health Cooperative of Puget Sound
Noralou Roos
Affiliation:
University of Manitoba
Petra Heppner
Affiliation:
University of British Columbia
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Diane E. Watson, Ph.D., M.B.A., B.Sc.O.T., Centre for Health Services and Policy Research, University of British Columbia, 4th Floor, 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3. (diane.watson@ihspr.ubc.ca)
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Abstract

Canadians have expressed concern that access to a family physician (FP) has declined precipitously. Yet FP-to-population ratios remained relatively stable over the last decade, and there were perceptions of physician surpluses, at least in urban centres, 10 years ago. We evaluated whether demographic changes among patients and FPs, and in the volume of care received and provided over the period, contribute to this paradox. Given the relationship between age and FP use in fiscal year 1991/1992, an aging population should have been associated with a 2 per cent increase in visits by 2000/2001. Likewise, given the relationship between FP age and workloads in 1991/1992, an aging workforce should have been associated with a 12 per cent increase in service provision a decade later. Yet visit rates and average FP workloads remained unchanged. There was an increase in age-specific rates of FP use among older adults and a decline in rates among the young, and an increase in age-specific workloads such that older FPs provided many more services than their predecessors (30%) and younger FPs provided many fewer (20%). In terms of impact on future requirements for FPs, both changes in age-specific rates of use, and changes in age-specific patterns of FP productivity, trump population aging as key drivers.

Résumé

Les Canadiens ont exprimé des préoccupations quant à la diminution rapide de l'accès aux médecins de famille (MF). Pourtant, la proportion de MF par rapport à la population est restée relativement stable au cours de la dernièredécennie. Par ailleurs, il y a dix ans, les gens avaient l'impression qu'il y avait un surplus de médecins, du moinsdans les milieux urbains. Nous avons étudié les changements démographiques parmi les patients et les MF, ainsi quela quantité de soins fournis et reçus au cours de cette période, afin de déterminer si cela avait contribué à ceparadoxe. Compte tenu du rapport entre l'âge et les visites chez les MF au cours de l'exercice 1991/1992, levieillissement de la population aurait dû engendrer une augmentation de 2 p. 100 des visites chez le médecin en2000/2001. De même, compte tenu du rapport entre l'âge des médecins et les charges de travail en 1991/1992, cevieillissement des effectifs aurait dû engendrer une augmentation de 12 p. 100 dans la prestation de services dixans plus tard. Pourtant, la fréquence des visites et la charge de travail moyenne des MF n'ont pas changé. Il y a euune augmentation du nombre de visites chez les MF pour les personnes âgées et une diminution de la fréquencedes visites chez les plus jeunes, ainsi qu'une augmentation de la charge de travail propre à certains groupes d'âge,les MF les plus âgés fournissant beaucoup plus de services que leurs prédécesseurs (30 p. 100) tandis que les plusjeunes MF en fournissaient beaucoup moins (20 p. 100). Du point de vue de l'incidence sur les besoins à venir enmatière de MF, les changements liés au taux de consultations par catégorie d'âge et les changements dans laproductivité des MF selon leur âge prennent tous les deux le dessus sur le vieillissement de la population à titre defacteurs fondamentaux.

Keywords

aging populationfamily physiciansaccessusephysician supplyvieillissement de la populationmédecins de familleaccèsutilisation des serviceseffectifs de médecins
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue S1: Health and Health Care Use Among Older Adults: Using Population-Based Information Systems to Inform Policy in Manitoba , Spring/Printemps 2005 , pp. 37 - 45
Copyright
Copyright © Canadian Association on Gerontology 2005

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