title: Diagnosing senescence: contributions to physician expenditure increases in british columbia, 1996/97 to 2005/06.
abstract: 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.
authors.affiliation: Assistant Professor and Associate Director, School of Population and Public Health, Centre for Health Services and Policy Research, Vancouver, BC.
authors.forename: Kimberlyn M
authors.initials: KM
authors.lastname: McGrail
authors.forename: Robert G
authors.initials: RG
authors.lastname: Evans
authors.forename: Morris L
authors.initials: ML
authors.lastname: Barer
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Kerluke
authors.forename: Rachael
authors.initials: R
authors.lastname: McKendry