Durand P J, Verreault R, Dugas M, Morin J, Paradis C
Unité de recherche en gériatrie de l'Université Laval, centre de recherche du Centre hospitalier de l'Enfant-Jésus.
Union Med Can. 1994 Apr;123(4):226-36.
The rapid aging of the population constitutes a new challenge for the health care delivery system. This paper presents the progression of use of several diagnostic and surgical procedures in the elderly in Quebec from 1981 to 1989. Data were obtained from claims to the Régie de l'assurance maladie du Québec for the years 1981, 1985 and 1989. The rate of coronary artery bypass surgery increased by more than 700% in people 65 years and over between 1981 and 1989. This increase was especially high in the oldest age group (q 75 years). There was also a significant increase in surgery for abdominal aortic aneurysm, while the rate of carotid endarterectomy remained stable for people 65 years and over during this period. The rates of all abdominal surgical procedures examined (appendicectomy, repair of hiatal and inguinal hernia, cholecystectomy and colectomy) were relatively stable in elderly during the study period. Total hip replacement more than doubled in people 65 years and over, while other types of hip arthroplasty significantly decreased over this period. All types of diagnostic procedures examined (coronary angiography, bronchoscopy, gastroduodenoscopy and retrograd cholangio-pancreatography) increased significantly, especially in very old people. This study suggests that surgical care is increasing in the elderly in Quebec. This progression is expected to continue in the coming years so that surgical care of the elderly will become a significant part of our health care delivery system.
人口的迅速老龄化给医疗保健系统带来了新的挑战。本文介绍了1981年至1989年魁北克老年人几种诊断和外科手术的使用进展情况。数据取自1981年、1985年和1989年向魁北克医疗保险局提交的理赔申请。1981年至1989年间，65岁及以上人群的冠状动脉搭桥手术率增长超过700%。这一增长在最年长的年龄组（75岁及以上）尤为显著。腹主动脉瘤手术也有显著增加，而在此期间，65岁及以上人群的颈动脉内膜切除术率保持稳定。在研究期间，所有检查的腹部外科手术（阑尾切除术、食管裂孔疝和腹股沟疝修补术、胆囊切除术和结肠切除术）的发生率在老年人中相对稳定。65岁及以上人群的全髋关节置换术增加了一倍多，而在此期间其他类型的髋关节置换术显著减少。所有检查的诊断程序（冠状动脉造影、支气管镜检查、胃十二指肠镜检查和逆行胰胆管造影）都显著增加，尤其是在高龄人群中。这项研究表明，魁北克老年人的外科护理正在增加。预计这一进展在未来几年将持续下去，从而使老年人的外科护理成为我们医疗保健系统的重要组成部分。
