Fragmented care in assisted living linked to lower family doctor attachment
Older adults residing within retirement homes in Ontario are less likely to have a regular family physician for ongoing care than other older adults.
A new study from the Institute for Clinical Evaluative Sciences (ICES) has found a significant increase in the number of hospital beds days used by patients who have received mechanical ventilation (breathing machines used to provide life support), highlighting a crucial trend that could help in planning for future healthcare resources.
Researchers examined over 150,000 hospital patients who received mechanical ventilation between 1992 and 2000 in Ontario to assess the annual incidence of ventilation and the hospital bed days used by these patients.
Results:
- By the year 2000, patients who had been ventilated used one in 16 hospital bed days, a 30% increase from 1992.
- As a proportion of total inpatient bed days, the number of days of ventilation increased by 69% during the study period.
- Although the actual number of people requiring mechanical ventilation increased by 9%, after being adjusted for age and gender the increase was 2%.
“These data highlight the increasingly important impact of mechanical ventilation on healthcare resources both within the ICU and throughout the entire hospital, “ said lead author and ICES Research Fellow Dr. Dale Needham.
“The difference in mechanical ventilation incidence when age, gender and additional patient illnesses were accounted for suggests that the growth in mechanical ventilation during the 1990s was due to an aging and increasingly sick population, rather than increasing use of this technology.
“Moreover, greater demand for ICU services is anticipated as ‘baby-boomers’ age. These trends in mechanical ventilation should be considered to ensure an adequate supply of human and capital resources in hospitals now and in the future.”
The study, “Mechanical ventilation in Ontario, 1992 – 2000: incidence, survival, and hospital bed utilization of noncardiac surgery in adult patients”, is in the July 7, 2004 issue of the journal Critical Care Medicine.
Author affiliations: ICES (Drs. Bronskill and Laupacis); Departments of Critical Care Medicine and Medicine (Drs. Needham and Sibbald), Department of Health Policy, Management and Evaluation (Dr. Bronskill), and Departments of Medicine and Health Policy, Management and Evaluation (Dr. Laupacis) University of Toronto; Department of Pulmonary and Critical Care Medicine (Dr. Needham), and Departments of Anesthesiology/Critical Care Medicine, Surgery, and Health Policy and Management (Dr. Pronovost) The Johns Hopkins University.
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners and practitioners to make decisions about care delivery and to develop policy.
FOR FURTHER INFORMATION, PLEASE CONTACT:
- Julie Argles
- Media Relations Officer, ICES
- (416) 480-4780 or cell (416) 432-8143
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