1. Beneath the calm surface: the changing of physician-service use in British Columbia, 1985/86 versus 1996/97.
- Author
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Barer, Morris L., Evans, Robert G., McGrail, Kimberlyn M., Green, Bo, Hertzman, Clyde, and Sheps, Samuel B.
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MEDICAL care costs , *PHYSICIAN services utilization , *MEDICAL care , *PUBLIC health - Abstract
Background: Although expenditures on health care are continually increasing and often said to be unsustainable, few studies have examined these trends at the level of services delivered to individual patients. We analyzed trends in the various components that contributed to changes in overall expenditures for physician services in British Columbia from 1985/86 to 1996/97. Methods: We obtained data on all fee-for-service payments to physicians in each study year using the British Columbia Linked Health Data set and analyzed these at the level of individual patients. We disaggregated overall billing levels by year into the following components: number of physicians seen by each patient, number of visits per physician, number of services rendered on each visit and average price of those services. We removed the effect of inflation on fees by adjusting to those in 1988. We used direct age-standardization to isolate and measure the effect of demographic changes. We used the Consumer Price Index to determine the effects of inflation. Results: Total payments to fee-for-service physicians in British Columbia rose 86.3% over the study period. The increase was entirely accounted for by the combined effects of population growth (28.9%), aging (2.1%) and general inflation (41.4%). Service use per capita rose 10.5%; this increase was offset by a... [ABSTRACT FROM AUTHOR]
- Published
- 2004
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