Recent trends in acute care hospital utilization in Ontario for diseases of the circulatory system.
OBJECTIVE
To describe trends in the use of acute care hospital services for diseases of the circulatory system in Ontario.


METHODS
Observational study.


METHODS
Information on diagnoses, procedures and demographic characteristics was obtained from routinely collected computerized abstracts of separations from all acute care hospitals in Ontario during 1979-80, 1983-84 and 1988-89. The data were combined with population estimates to calculate overall separation rates and rates specific for age, diagnosis and procedure. Resource intensity weights were used to estimate changes in resource use.


RESULTS
The overall separation rate increased by 3% and the resource-intensity-weighted separation rate by 12% from 1979-80 to 1988-89. The overall medical separation rate increased by 2%, whereas the surgical rate increased by 12%. The surgical separation rate increased among patients 55 to 79 years of age but decreased in all the other adult age groups. The separation rates for coronary artery bypass surgery and cardiac valve surgery increased rapidly among patients 65 years of age or older. The medical separation rate decreased for patients of all ages except those less than 5 years and those 80 years or more. The medical separation rates decreased by less than 1% for diagnoses related to ischemic heart disease (IHD) and increased dramatically for coronary artery revascularization.


CONCLUSIONS
The increasing elderly population has not resulted in large increases in acute care hospital utilization for diseases of the circulatory system. The impact of an aging population has been balanced by decreased utilization rates in the younger groups. The intensity of hospital care has risen primarily because of increases in surgical rates, especially in the elderly population. The large decrease in the rate of death from IHD over the past two decades has not been associated with similar decreases in acute care hospital utilization for this disorder.
Anderson
G M
GM
Department of Health Care and Epidemiology, University of British Columbia, Vancouver.
Pulcins
I R
IR
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy; D003625:Data Collection; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*