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. 2011 Aug;7(1):41-54.

Diagnosing senescence: contributions to physician expenditure increases in british columbia, 1996/97 to 2005/06

Kimberlyn M McGrail  1 , Robert G Evans, Morris L Barer, Kerry J Kerluke, Rachael McKendry
Affiliations

Diagnosing senescence: contributions to physician expenditure increases in british columbia, 1996/97 to 2005/06

Kimberlyn M McGrail et al. Healthc Policy. 2011 Aug.

Abstract
in English, French

Conventional wisdom holds that Canada suffers from a physician shortage, yet expenditures for physicians' services continue to increase rapidly. We address this apparent paradox, analyzing fee-for-service payments to physicians in British Columbia in 1996/97 and 2005/06. Age-specific per capita expenditures (adjusted for fee changes) rose 1% per year over this period, adding $174 million to 2005/06 expenditures. We partition these increases into changes in the proportion of the population seeing a physician; the number of unique physicians seen; the number of visits per physician; and the average expenditure per visit. Expenditures on laboratory and imaging services, particularly for the elderly and very elderly, have increased dramatically. By contrast, primary care services for the non-elderly appear to have declined. The causes and health consequences of these large changes deserve serious attention.

L'opinion générale soutient que le Canada connaît une pénurie de médecins, cependant les dépenses pour les services des médecins continuent d'augmenter rapidement. Nous nous penchons sur ce paradoxe apparent en analysant les paiements à l'acte remis aux médecins de la Colombie-Britannique, en 1996–1997 et en 2005–2006. Les dépenses par tête en fonction de l'âge (ajustées selon les changements d'honoraires) ont augmenté de 1 % par année pendant cette période, ajoutant ainsi 174 millions de dollars aux dépenses pour 2005–2006. Nous avons segmenté ces augmentations selon les changements dans la proportion de la population qui consulte un médecin; le nombre de médecins consultés; le nombre de consultations par médecin; et la dépense moyenne par consultation. Les dépenses pour les services de laboratoire et d'imagerie, particulièrement pour les aînés, ont augmenté de façon spectaculaire. À l'opposé, les services de soins primaires pour les non-aînés semblent avoir décliné. Il est important de porter une attention particulière aux causes, et aux répercussions sur la santé, de ces grands changements.

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Figures

FIGURE 1.
FIGURE 1.
Per capita expenditures on physician services, Canada and British Columbia, 1975—2009
See this image and copyright information in PMC

References

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