Beneath the calm surface: the changing of physician-service use in British Columbia, 1985/86 versus 1996/97

Barer, Morris L.; Evans, Robert G.; McGrail, Kimberlyn M.; Green, Bo; Hertzman, Clyde; Sheps, Samuel B.
March 2004
CMAJ: Canadian Medical Association Journal;3/2/2004, Vol. 170 Issue 5, p803
Academic Journal
Background: Although expenditures on health care are continually increasing and often said to be unsustainable, few studies have examined these trends at the level of services delivered to individual patients. We analyzed trends in the various components that contributed to changes in overall expenditures for physician services in British Columbia from 1985/86 to 1996/97. Methods: We obtained data on all fee-for-service payments to physicians in each study year using the British Columbia Linked Health Data set and analyzed these at the level of individual patients. We disaggregated overall billing levels by year into the following components: number of physicians seen by each patient, number of visits per physician, number of services rendered on each visit and average price of those services. We removed the effect of inflation on fees by adjusting to those in 1988. We used direct age-standardization to isolate and measure the effect of demographic changes. We used the Consumer Price Index to determine the effects of inflation. Results: Total payments to fee-for-service physicians in British Columbia rose 86.3% over the study period. The increase was entirely accounted for by the combined effects of population growth (28.9%), aging (2.1%) and general inflation (41.4%). Service use per capita rose 10.5%; this increase was offset by a...


Related Articles

  • Part B Premiums to Increase 12 Percent.  // hfm (Healthcare Financial Management);May2005, Vol. 59 Issue 5, p16 

    This article reports that Monthly Medicare Part B premiums will increase from $78.20 to $87.70 next year, a 12 percent increase, according to the recent Medicare and Social Security trustees report. Part B of the Supplementary Medical Insurance fund pays for physician visits and outpatient...

  • A Critique of the Harvard Resource-Based Relative Value Scale. McMahon Jr., Laurence F. // American Journal of Public Health;Jul1990, Vol. 80 Issue 7, p793 

    Physician payment reform has assumed a prominent place in the national health policy debate. A Key component in this debate is the Harvard Resource-Based Relative Value Scale (RBRVS). The Harvard research effort relied upon several necessary methodologic assumptions and compromises that must be...

  • Refinement and Expansion of the Harvard Resource-Based Relative Value Scale: The Second Phase. Becker, Edmund R.; Dunn, Daniel; Braun, Peter; Hsiao, William C. // American Journal of Public Health;Jul1990, Vol. 80 Issue 7, p799 

    The Harvard resource-based relative value scale (RBRVS) for physician services has assumed a critical role in physician payment reform. We have demonstrated that the relative resource costs of providing physician services can be defined and measured in a rational and systematic way and that the...

  • High BP amounts to high costs.  // PharmacoEconomics & Outcomes News;9/23/2006, Issue 512, p7 

    The article discusses research being done on the incremental expenditure of treating hypertension in the U.S. It references a study by S. Balu et al published in the August 2006 issue of the "American Journal of Hypertension." The annual cost of treating hypertension include prescription...

  • Trends in National and Medicare Physician Expenditures: CYs 1970-93.  // Health Care Financing Review;Summer95 Supplement, Vol. 16, p90 

    The article discusses the trends in national and medicare physician expenditures in the U.S. from 1970 to 1993. Medicare personal health care expenditure (PHCE) for physician services were $34.8 billion in 1993 and accounted for about 20 percent of all physician PHCE in the country. Medicare...

  • The Health Care Cost of Dying: A Population-Based Retrospective Cohort Study of the Last Year of Life in Ontario, Canada. Tanuseputro, Peter; Wodchis, Walter P.; Fowler, Rob; Walker, Peter; Bai, Yu Qing; Bronskill, Sue E.; Manuel, Douglas // PLoS ONE;Mar2015, Vol. 10 Issue 3, p1 

    Background: Coordinated and appropriate health care across sectors is an ongoing challenge, especially at the end-of-life. Population-level data on end-of-life health care use and cost, however, are seldom reported across a comprehensive array of sectors. Such data will identify the level of...

  • Director's Message. Landefeld, J. Steven // Survey of Current Business;Jun2007, Vol. 87 Issue 6, piii 

    The article discusses various reports published within the issue, including "Beyond Drug and Hospital Costs: Comprehensive Accounting for Health Care," and "Approaches for Measuring the Cost of Health Care Services."

  • A Plea For Cost- Effectiveness, or at Least Avoiding Public Health Malpractice. Roberts, Leslie F. // American Journal of Public Health;Sep2009, Vol. 99 Issue 9, p1546 

    The author discusses the mission of public health that attempts to provide the most benefit for society with available limited resources. He discusses the advocacy of cost-effectiveness in public health that is at odds with the medical approach to service. He mentions the historical...

  • New Zealand's contradictory health statistics. Essex, Charles // BMJ: British Medical Journal (International Edition);5/23/92, Vol. 304 Issue 6838, p1330 

    Focuses on the introduction of measures to overcome health costs by the New Zealand government. Charges for patients attending general practices and hospitals; Reduction of government subsidies for patients; Dependence of several family on welfare benefits.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics