Article

This article examines two competing hypotheses for the impact of
disability and age on health service utilisation in Canada: the double jeopardy
and age-as-leveller hypotheses. METHOD: The study uses a retrospective cohort
design to examine the effect of age and disability on four aspects of health
service utilisation: family doctor, medical specialist, hospital and homecare.
The cohort was assembled from the longitudinal component of the National
Population Health Survey. The effective sample size for this analysis was 1629.
RESULTS: This study showed that disability is a stronger predictor of doctor and
hospital utilisation than age. No significant relationship was found between age
and specialist use, and there were only small to moderate increases in the use of
family doctors and hospitals with each 5-year increment of age over 65. There is
a strong association between the use of home care and both age and disability.
Results support the age-as-leveller hypothesis, in that negative interaction
effects were found between age and disability for use of both family physicians
and medical specialists. In other words, age and disability together have an
effect that is less than would be expected, given the main effects of each.
CONCLUSION: The results of this study support the importance of disability as an
indicator of health service utilisation. Rehabilitation practitioners are
encouraged to continue to sensitise other members of the health care team to the
importance of disability as a way of understanding health and health service use.

Langue : ANGLAIS