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Background
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?

Text begins

Background

Seniors constitute the largest group of hospital users.  The increasing share of immigrants in Canada’s senior population can affect the demand for hospital care.

Data and methods

This study used the linked 2006 Census-Hospital Discharge Abstract Database to examine hospitalization during the 2004-to-2006 period, by immigrant status, of Ontario seniors living in the community. Hospitalization was assessed with logistic regressions; cumulative length of stay, with zero-truncated negative binomial regressions. All-cause hospitalization and hospitalizations specific to circulatory and digestive diseases were examined.

Results

Immigrant seniors had significantly low age-/sex-adjusted odds of hospitalization, compared with Canadian-born seniors (OR = 0.81). The odds varied from 0.4 among East Asians to 0.89 among Europeans, and rose with length of time since arrival from 0.54 for recent (1994 to 2003) to 0.86 for long-term (before 1984) immigrants. Adjustment for demographic and socio-economic characteristics did not change the overall patterns. Immigrants’ cumulated length of hospital stay tended to be shorter than or similar to that of Canadian-born seniors.

Interpretation

Immigrant seniors, especially recent arrivals, had lower odds of hospitalization and similar time in hospital, compared with Canadian-born seniors. These patterns likely reflect differences in health status. Variations by world region and disease reflect the diverse health care needs of immigrant seniors.

Keywords

Aging, census, databases, health services, hospitalization, length of stay, medical record linkage

Findings

The percentage of people aged 65 or older in the Canadian population rose from 8% in 1960 to 15% in 2011; by 2036, the figure is expected to be at least 23%. Population aging affects the demand for and cost of health care services, given that seniors account for about 45% of provincial/territorial government health care dollars.6 Hospitals represented an estimated 29% of health care expenditures in 2012. Seniors are not only the largest user group, but per capita spending on hospital visits are consistently higher among seniors. [Full Text]

Authors

Edward Ng (Edward.ng@statcan.gc.ca), Claudia Sanmartin and Doug Manuel are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6. Doug Manuel is also with the University of Ottawa. Jack Tu is with the Institute for Clinical Evaluative Sciences and the University of Toronto.

What is already known on this subject?

  • Immigrants make up a substantial share of the senior population, the age group most likely to be hospitalized.  
  • Because hospital records do not indicate immigration status, information about immigrant seniors’ use of hospital services is limited.
  • A pilot linkage of landing records to health services data found that immigrant seniors used relatively fewer hospital services, although hospitalization rates increased with duration of residence.

What does this study adds?

  • Based on linked census-hospital discharge administrative data for Ontario, odds of hospitalization were lower among immigrant seniors, compared with Canadian-born seniors.
  • Immigrant seniors’ time in hospital was generally less than or no different from that of the Canadian-born.
  • Variations by world region in hospitalization and length of time in hospital reflected differences in health care needs among immigrants.
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