BY CARMEN CHAI, POSTMEDIA NEWS JANUARY 28, 2011
It's their health, not the age of Canadian seniors that is the main factor when determining the number of medical services they use, according to a report that examines the elderly population's reliance on the health-care system.
"In society, many of us may expect that with age comes chronic conditions but this isn't the case. It became apparent that it's the number of chronic conditions that seniors have, not their increasing age, that drives their health-care utilization," said Greg Webster, director of primary health care for the Canadian Institute for Health Information, which released the report Thursday.
"Once people get to three or more chronic conditions, their quality of life deteriorates and their use of health care goes through the roof."
About 1.1 million Canadian seniors are living with at least three chronic conditions, such as diabetes, high blood pressure, arthritis or cancer. The group accounted for 40 per cent of the health care used by seniors, according to the CIHI study. Healthy seniors — that is, those without such ongoing conditions, who were at least 85 years old, made fewer than half the number of visits to doctors' offices as younger seniors who had many chronic illnesses, though, Webster said.
CIHI collaborated with the Health Council of Canada and Statistics Canada to design the study, which examined the prevalence of 11 chronic illnesses in seniors and the kind of services they needed. The most common chronic illnesses among seniors were high blood pressure, which affects two million seniors, followed by arthritis, which affects 1.2 million seniors.
According to previous CIHI research, health care for a senior between 65 and 69 years old costs $5,828; for a senior 70 to 74 years old, the average cost is $8,803; and for seniors 70 to 79 years old, the cost is $10,989 on average. About $18,160 is spent on each senior who is more than 80 years old.
But it's the chronic illnesses — with their most common forms, such as Type 2 diabetes and osteoarthritis, appearing between the ages of 50 and 60 — that make up a big chunk of that spending, said Dr. Bill Hogg, a University of Ottawa professor and research director at the university's Elisabeth Bruyere Research Institute.
Similar patterns of health care exist among adults between 45 and 64 years old. Unhealthy middle-aged Canadians with three or more chronic conditions made six times more visits to the doctor's office, hospital or emergency room than their peers without health conditions, the report showed. About half of Canadians in this age group have at least one chronic condition already.
Hogg said that as the large group of baby boomers ages in Canada, cases of chronic illness in seniors will climb, increasing the burden provincial health-care systems already face.
"People are concerned about the cost implications and about the amount of disability and suffering as projections are that the number of people living with these diseases will increase dramatically. They're all quite significant (diseases), they're not just minor lashes, but they've become a reality today," he said, noting that some Canadian seniors are dealing with a combination of six or more chronic illnesses.
The report recommends that doctors and patients of all ages make maintaining good health and regular exercise a priority to reduce the risk of chronic conditions.
"We shouldn't accept that it's going to be this way," Webster said.
The study suggested only two in five seniors said they had talked to their doctors about what they could do to improve their health: from quitting smoking, exercising more and drinking less alcohol.
"If we take better care, seniors would be healthier and happier and they'd need less health care, leading to a more sustainable system," Webster said.
In 2008, seniors consumed almost 44 per cent of all provincial and territorial government health spending, although they only comprised about 14 per cent of the population, he said.
Handling comorbidity — the accumulation of chronic diseases — results in frequent appointments with doctors and specialists, Hogg said.
Seniors with three or more conditions were making three times more health-care visits than their healthy peers, the report suggested. A patient with three conditions would visit a doctor at least once a month while a healthy 30-year-old man would probably visit the doctor once every five years, Hogg said.
The seniors also reported taking an average of six prescription drugs regularly, which also concerned the researchers.
Hogg said the usage of multiple drugs to reduce or to treat symptoms is "not trivial" as some seniors who were routinely taking multiple medications reported side-effects that were so severe, they needed medical attention. Hogg said the side effects could be minor to very serious, from a dry mouth or nausea to allergic reactions that can led to trouble breathing.
The highest percentage of seniors with chronic illnesses was recorded in Newfoundland and Labrador, where 85 per cent of seniors had at least one chronic illness while the lowest was Quebec, followed by British Columbia and Ontario, the report suggested.
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