Canadian Institute for Health Information
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Health Care in Canada, 2011:
A Focus on Seniors and Aging
An Overview
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HCIC 2011: A Focus on Seniors and Aging
• Today’s Canadian seniors live longer and are healthier
than ever before.
• Seniors are frequent health system users, costing more
than any other segment of the population.
• In 2011, Canada’s population entered a period of
accelerated aging.
• Although modest to date, population aging will likely
have a larger impact on the health care system in future.
• The report examined seniors’ current utilization patterns
and considered ways the system can adapt to meet the
aging population’s future needs.
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Accelerated Aging
Proportion of Canadians age 65+ will almost double in 25
years: from 14% in 2011 to 25% in 2036.
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Canada’s Seniors:
Healthier and Living Longer
• Life expectancy at age 65 continues to increase; 86.1
years for women, 82.9 years for men
• Indicators of health status show a mixed picture with
advancing age:
Increases
in . . .
Decreases
in . . .
Chronic disease prevalence
Prevalence of functional limitations
Obesity rates
Smoking
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Spending Growth Lower for Seniors
Between 1998 and 2008, annual increases in total per capita
public-sector health expenditures were lower for seniors
(5.2%) than for younger adults (6.3%).
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Aging:
One Factor in Health Spending Increases
• Between 1998 and
2008, aging was a
modest driver of
increases in publicsector health
expenditure for
hospitals (1%),
physicians (0.6%) and
drugs (1%).
• Aging has a greater
impact (2.3%) on
expenditures for longterm institutional care.
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Seniors: Heavy Users of Health Care
Seniors represent 14% of population, yet utilize
• 45% of all provincial/territorial public-sector health
spending;
• 40% of acute hospital stays;
• 85% of hospital-based continuing care;
• 82% of home care; and
• 95% of residential care.
They are also more likely than younger adults to visit
family doctors frequently and make claims for publicly
funded prescription drugs.
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Primary Health Care:
Key to Keeping Seniors Healthy
• 95% of seniors have a family physician.
• 45% report same- or next-day appointments,
while 34% wait 6 or more days.
• 44% received no dental care in previous year,
compared with 27% of adults age 45 to 64.
• Seniors less likely to visit psychologists, social
workers and alternative providers, compared
with younger adults.
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Prescription Drugs:
Also Key to Keeping Seniors Healthy
•
•
•
With increasing age comes increased
prevalence of chronic conditions, and
an increasing need for prescription
drugs to manage them.
In 2009, 63% of seniors on public drug
programs claimed ≥5 drugs from
different classes, while 23% claimed
≥10.
Five of the top 10 drug classes used by
seniors treat high blood pressure and
heart failure.
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Drug Safety Is a Concern
• In 2009, ~1 in 10 seniors were taking drugs that were
potentially inappropriate.
• Seniors are at increased
risk of drug side-effects
and interactions,
compared with younger
adults.
Age-Sex Standardized Rate of Chronic Beers Drug Use
• Seniors are more likely than younger adults to take overthe-counter drugs
and supplements.
Seniors in Community Settings
• ~97% of formal home care recipients also have
informal caregivers.
• ~17% of informal
caregivers report
distress in their role.
• Caregiver distress
increases with time
spent providing care.
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Seniors in Residential Care Settings
• From 1981 to 2006, rates of institutionalization among seniors
have ↓, but since 2004, intensity of care provided in
residential settings has ↑
• Seniors in residential care are more likely to be older (85+
years), unmarried and functionally dependent compared with
those in community settings.
Characteristic
Descriptive
Home Care HCRS
(%)
Residential Care
CCRS (%)
Age
% accessed seniors
pop age 85+
40
57
Marital Status
Not married
64
76
Functional Status
(Activities of Daily
Living)
Extensive assistance/
dependence
18
74
Cognitive
Performance Scale
Moderate to severe
14
60
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Room to Improve:
Managing Chronic Conditions
Compared with
younger adults,
seniors
• Seek care in EDs
more often
•Spend more time
once in EDs
• Are hospitalized at
higher rates for
conditions sensitive
to ambulatory care
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Room to Improve: Falls Injuries
Falls are the leading cause of injury hospitalizations for
seniors.
Care Sector
Percentage of
Seniors (65+)
Experiencing a Fall
Time Frame
Acute Care
8%
Prior to admission
Emergency Dept
9%
Prior to visit
Mental Health (Inpatient)
12%
30 days prior to admission
assessment
Residential Care
12%
Within 30 days of assessment
Complex Continuing Care
7%
Within 30 days of assessment
Home Care
28%
Within 90 days of assessment
Prior to Admission Visit
Within Care Setting
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Room to Improve: Flow Across Care Settings
47% of seniors designated ALC are waiting for
LTC placement.
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Looking Ahead
• In the near future, the health care system will likely need
to adapt to meet the changing needs of the aging
population.
• Areas where decision-makers could focus include the
following:
1. Improving integration across the health care continuum
can lead to better care for seniors.
2. Increasing focus on prevention can help prevent or delay
onset of chronic conditions and disability for seniors.
3. Adopting new health innovations and technology can
help ensure that seniors are receiving appropriate care.
4. Collecting, managing, and reporting better information
can better inform policy-making.
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About CIHI’s Health Care in Canada series
• Annual report first published in 2000
• Brings together data and information from many sources
for broad examination of significant issue(s)
• Can access entire Health Care in Canada series at
www.cihi.ca/hcic (free download)
• For more information, send an email to
healthreports@cihi.ca.
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Thank You
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