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May 8, 1996, Vol 275, No. 18 >
ARTICLE | May 8, 1996

Health Care for Older People: Title and subTitle BreakA Look Across a Frontier FREE

J. Grimley Evans, MD, FRCP, FFPHM
[+] Author Affiliations

Corresponding author: J. Grimley Evans, MD, FRCP, FFPHM, Department of Clinical Geratology, Radcliffe Infirmary, Oxford OX2 6HE, England.


JAMA. 1996;275(18):1449-1450. doi:10.1001/jama.1996.03530420077042
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References

The United States and Canada are 2 federal nations separated geographically by an arbitrary line of latitude but culturally by 200 years of history. The ancestry of their institutions lies respectively, albeit remotely, in the anarchy of frontiers and the order of empire. Different assumptions about the natural way to organize society emerge in the pattern of their health services. The United States presents to the world a vision of rampant entrepreneurialism bridled by the enlightened self-interest of citizens and spurred by sporadic pricks of compassion. Canada's more collectivist tradition emerges in a concern that its health services should make sense in the context of equity and the public health, an ideal that has yet to be fully realized.1 It has, however, retained the tradition of the physician as a fee-paid professional, and only in the salaried medical staff of some primary health care centers in Quebec does one

REFERENCES

1 +
Katz SJ, Hofer TP.  Socioeconomic disparities in preventive care persist despite universal coverage. JAMA . 1994;;272:530-534.
2 +
Kaletsky A.  The National Health Service can survive as it is, thank you. The Times . (September 21) , 1995;:27.
3 +
Fuchs VR, Hahn JS.  How does Canada do it? a comparison of expenditures for physicians' services in the United States and Canada. N Engl J Med . 1990;;323:884-890.
4 +
Redelmeier DA, Fuchs VR.  Hospital expenditures in the United States and Canada. N Engl J Med . 1993;;328:772-778.
5 +
Liptzin B.  Canadian and US systems of care for the mentally ill elderly. Gerontologist . 1984;;24:174-178.
6 +
Anderson GM, Newhouse JP, Roos LL.  Hospital care for elderly patients with diseases of the circulatory system: a comparison of hospital use in the United States and Canada. N Engl J Med . 1989;;321:1443-1448.
7 +
Rouleau JL, Moyé LA, Pfeffer MA, et al.  A comparison of management patterns after acute myocardlal infarction in Canada and the United States. N Engl J Med . 1993;;328:779-784.
8 +
Mark DB, Naylor CO, Hlatky MA, et al.  Use of medical resources and quality of life after acute myocardial infarction in Canada and the United States. N Engl J Med . 1994;;331:1130-1135.
9 +
Coyte PC, Wright JG, Hawker GA, et al.  Waiting times for knee-replacement surgery in the United States and Ontario. JAMA . 1994;;331:1068-1071.
10 +
Welch WP, Verrilli D, Katz SJ, Latimer E.  A detailed comparison of physician services for the elderly in the United States and Canada. JAMA . 1996;;275:1410-1416.
11 +
Bergman H, Clarfield AM, Ouslander J, Kane R, Burton JR, Gold S.  Same patients, different systems: clinical implications for the care of the elderly. J Am Geriatr Soc . 1992;;40:1178-1182.
12 +
Barer ML, Hertzman C, Miller R, Pascali MV.  On being old and sick: the burden of health care for the elderly in Canada and the United States. J Health Polit Policy Law . 1992;;17:763-782.
13 +
Woolhandler S, Himmelstein DU.  The deteriorating administrative efficiency of the US health care system. N Engl J Med . 1991;;324:1253-1258.
14 +
Katz SJ, Mizgala HF, Welch HG.  British Columbia sends patients to Seattle for coronary surgery: bypassing the queue in Canada. JAMA . 1991;;266:1108-1111.
15 +
Whitcoinb ME, Desgroseilliers JP.  Primary care medicine in Canada. N Engl J Med . 1992;;326:1469-1472.
16 +
Iglehart JK.  Canada's health care system faces its problems. N Engl J Med . 1990;;322:562-568.
17 +
Grimley Evans J.  Prevention of age-associated loss of autonomy: epidemiological approaches. J Chronic Dis . 1984;;37:353-363.
18 +
Grimley Evans J.  Evidence-based and evidence-biased medicine. Age Ageing . 1995;;24:461-463.
19 +
Callahan D.  Aging and the ends of medicine. Ann N Y Acad Sci . 1988;;530:125-132.
20 +
Grimley Evans J.  Age and equality. Ann N Y Acad Sci . 1988;;530:118-124.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Katz SJ, Hofer TP.  Socioeconomic disparities in preventive care persist despite universal coverage. JAMA . 1994;;272:530-534.
2 +
Kaletsky A.  The National Health Service can survive as it is, thank you. The Times . (September 21) , 1995;:27.
3 +
Fuchs VR, Hahn JS.  How does Canada do it? a comparison of expenditures for physicians' services in the United States and Canada. N Engl J Med . 1990;;323:884-890.
4 +
Redelmeier DA, Fuchs VR.  Hospital expenditures in the United States and Canada. N Engl J Med . 1993;;328:772-778.
5 +
Liptzin B.  Canadian and US systems of care for the mentally ill elderly. Gerontologist . 1984;;24:174-178.
6 +
Anderson GM, Newhouse JP, Roos LL.  Hospital care for elderly patients with diseases of the circulatory system: a comparison of hospital use in the United States and Canada. N Engl J Med . 1989;;321:1443-1448.
7 +
Rouleau JL, Moyé LA, Pfeffer MA, et al.  A comparison of management patterns after acute myocardlal infarction in Canada and the United States. N Engl J Med . 1993;;328:779-784.
8 +
Mark DB, Naylor CO, Hlatky MA, et al.  Use of medical resources and quality of life after acute myocardial infarction in Canada and the United States. N Engl J Med . 1994;;331:1130-1135.
9 +
Coyte PC, Wright JG, Hawker GA, et al.  Waiting times for knee-replacement surgery in the United States and Ontario. JAMA . 1994;;331:1068-1071.
10 +
Welch WP, Verrilli D, Katz SJ, Latimer E.  A detailed comparison of physician services for the elderly in the United States and Canada. JAMA . 1996;;275:1410-1416.
11 +
Bergman H, Clarfield AM, Ouslander J, Kane R, Burton JR, Gold S.  Same patients, different systems: clinical implications for the care of the elderly. J Am Geriatr Soc . 1992;;40:1178-1182.
12 +
Barer ML, Hertzman C, Miller R, Pascali MV.  On being old and sick: the burden of health care for the elderly in Canada and the United States. J Health Polit Policy Law . 1992;;17:763-782.
13 +
Woolhandler S, Himmelstein DU.  The deteriorating administrative efficiency of the US health care system. N Engl J Med . 1991;;324:1253-1258.
14 +
Katz SJ, Mizgala HF, Welch HG.  British Columbia sends patients to Seattle for coronary surgery: bypassing the queue in Canada. JAMA . 1991;;266:1108-1111.
15 +
Whitcoinb ME, Desgroseilliers JP.  Primary care medicine in Canada. N Engl J Med . 1992;;326:1469-1472.
16 +
Iglehart JK.  Canada's health care system faces its problems. N Engl J Med . 1990;;322:562-568.
17 +
Grimley Evans J.  Prevention of age-associated loss of autonomy: epidemiological approaches. J Chronic Dis . 1984;;37:353-363.
18 +
Grimley Evans J.  Evidence-based and evidence-biased medicine. Age Ageing . 1995;;24:461-463.
19 +
Callahan D.  Aging and the ends of medicine. Ann N Y Acad Sci . 1988;;530:125-132.
20 +
Grimley Evans J.  Age and equality. Ann N Y Acad Sci . 1988;;530:118-124.

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