Comparing the health services utilization of long-term-care residents, home-care recipients, and the well elderly

Can J Nurs Res. 2005 Dec;37(4):138-54.


Research has typically supported the concern that health services utilization increases with aging. Yet most health services utilization studies have focused on the use of 1 as opposed to all health services, the use of health services over 1 year as opposed to a longer period, and the use of health services during the 1970s or 1980s. Current, comprehensive utilization studies are needed in order to better inform health policy and health services decision-making. This study was designed to compare the health services utilization of 3 groups of seniors: those residing in long-term-care (LTC) facilities, those receiving home care, and those neither institutionalized nor receiving home care. Individual-anonymous and population-based inpatient hospital data, ambulatory care (day surgery, outpatient clinic, and emergency room) data, and physician services data collected by the health ministry of the Canadian province of Alberta over a 2-year period were analyzed using descriptive and comparative statistical tests available in the SPSS computer program. With the exception of physician and LTC services, LTC residents were the least likely to use health services. Furthermore, and despite concerns that LTC residents may be stigmatized or rationed with regard to access to tertiary care, the data indicate that LTC residents are not disadvantaged in terms of type or scope of hospital services. These and other findings suggest an appreciation for LTC in managing both the health and the care needs of the oldest seniors. The findings also raise concerns about the adequacy of formal home care and of the health care received by the well elderly.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alberta
  • Ambulatory Care / statistics & numerical data
  • Ambulatory Surgical Procedures / statistics & numerical data
  • Community Health Planning
  • Emergency Service, Hospital / statistics & numerical data
  • Geriatric Assessment
  • Health Care Surveys
  • Health Services Needs and Demand
  • Health Services for the Aged / statistics & numerical data*
  • Health Status
  • Home Care Services* / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Institutionalization / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Nursing Homes* / statistics & numerical data
  • Socioeconomic Factors