Addendum to “Bending the Medicare Cost Curve in 12 Months or Less”: AHS Analysis for Sample of Pure North Seniors (55-plus)

Abstract

As part of our analysis in the paper published in January 2015, “Bending the Medicare Cost Curve in 12 Months or Less: How Preventative Health Care Can Yield Significant Near-Term Savings for Acute Care in Alberta,”1 we had carried out analyses of sub-groups of interest, such as workers at Canadian Natural Resources Ltd. (CNRL) and seniors (participants aged 55-plus) that, for reasons of length, we did not include in the published paper. The details for the data, the models estimated, the statistics calculated and the sample inclusion and exclusion restrictions are described in the full paper that was peer reviewed. This addendum discusses the results of the analysis of the sample of seniors (participants aged 55 and up at the time of joining Pure North, n=5,516, made up of 2,758 Pure North participants and 2,758 age- and sex-matched controls). The models estimated are described on pages 9 and 10 of the published paper. Persisting participants are Pure North joiners who have a 25OHD (vitamin D blood serum) measure at the time of joining and one year later. We interpret participants with two 25OHD one year apart as persisting in the Pure North program but we do not infer the degree of adherence to the program. The In-Clinic Seniors Program (ICP) sub-sample of Pure North senior participants had over 90 per cent persistence in the program for at least one year. For this sub-sample, relative to the frequency of hospital and emergency department visits of the ICP seniors program participants and matched controls in the year prior to joining the program, the program reduces hospital visits for seniors in the program by 22 per cent, emergency department visits by 34 per cent and avoids 22 per cent of annual health-care costs. For the 68 per cent of the full sample of Pure North participants aged 55 and over who we can confirm persisted in the program for at least one year, relative to the frequency of hospital and emergency department visits of the program participants and matched controls in the year prior to joining the program, the program reduces hospital visits for seniors persisting in the program by 39 per cent and emergency department visits by 24 per cent. These reductions in health care system contacts result in public health-care expenditures avoided of 35 per cent per year. These magnitudes are comparable to what we calculated for the overall and Vital 2.2 samples in the full 2015 report. Not accounted for in those direct health-care costs avoided is the relief that preventative care can provide to the medical treatment system. Scaled to the population level, the reductions observed in the Pure North seniors sample would represent at least six per cent fewer visits to Alberta emergency departments per year and reduce the need for hospital beds by at least six per cent in the Alberta hospital system. In terms of freed-up hospital beds, this is equivalent to adding another Foothills Medical Centre to the Alberta health-care system.