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  1. A detailed comparison of physician services for the elderly in the United States and Canada.

    Article - En anglais

    Objective

    - To assess the relative volume and price of physician services in Canada and the United States.

    Design

    - A comparative analysis of 1992 claims data from Canadian provincial ministries of health and from the US Health Care Financing Administration.

    Patients

    - All elderly individuals in the 3 largest Canadian provinces, Ontario, Quebec, and British Columbia, and a 1% random sample of US elderly Medicare beneficiaries not enrolled in health maintenance organizations.

    Main Outcome Measure

    - The volume of physician services measured in terms of the relative value units used in the Medicare fee schedule to calculate payments, with services disaggregated into clinically meaningful categories.

    Results

    - Canadian elderly receive a higher volume of physician services than US elderly.

    Because the provinces examined paid a much lower price per service, Canada had overall lower expenditures per elderly person than the United States.

    Canadian elderly received 44% more evaluation and management services, but 25% fewer procedures.

    Canada has a disproportionately lower volume of procedures for which there is low clinical consensus as to when they are indicated.

    Such procedures include cataract extractions and knee replacements.

    Conclusion

    - The lower prices for physician services in Canada permit Canadian elderly to receive a higher volume of evaluation and management services with lower expenditures than US elderly.

    Expenditures for procedural services, o...

    Mots-clés Pascal : Service santé, Canada, Etude comparative, Médecin, Economie santé, Coût, Vieillard, Amérique du Nord, Amérique, Homme

    Mots-clés Pascal anglais : Health service, Canada, Comparative study, Physician, Health economy, Costs, Elderly, North America, America, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0264209

    Code Inist : 002B30A04B. Création : 199608.