Chronic conditions more than age drive health system use in Canadian seniors.

Which has more impact on health status and the use of healthcare services among seniors: age or the number of chronic conditions? To answer this question, we used responses from the 2008 Canadian Survey of Experiences with Primary Health Care to assess the effect of these two factors on seniors' self-perceived health status, prescription medication use and healthcare service use. We discovered that seniors with at least three chronic conditions were more likely to report poor health, take more prescription medications and use more healthcare services than seniors with two or fewer chronic conditions. The number of chronic conditions is better than age as a predictor of self-reported health status, prescription medication use and healthcare service use by seniors. Seniors with at least three conditions represented 24% of all seniors, but they accounted for 40% of the use of healthcare services. Health policies and programs focused on the prevention and improved management of co-morbidities among seniors could have a significant and positive impact on seniors' health (including self-perceived health status) and their use of healthcare services.

Ejections of young children in motor vehicle crashes.

PURPOSE: The purpose of this study was to report the incidence of ejection from the vehicle among children involved in motor vehicle crashes, and to describe a novel mode of ejection from child safety seats. METHODS: The U.S. National Automotive Sampling System General Estimates System and the Fatality Analysis Reporting System databases from 1995 through 1999 were analyzed. A prospective two-center study of children involved in severe car crashes in Canada was performed. RESULTS: Only 0.2% of 5.5 million children involved in crashes experienced ejection, but 1924 (29%) of 6570 child fatalities involved ejections. Only 2.2% of children experienced rollover crashes, but these contributed 1832 (28%) of 6570 child passenger fatalities. Among 56 crashes, 5 restrained young children were ejected, 4 in rollover crashes. Ejection of a toddler through the shoulder straps of a forward-facing child safety seat was the mechanism of ejection in three of the five cases. CONCLUSION: Ejection from the vehicle is common (29%) among fatally injured children. Shoulder straps alone (as found in T-shield or overhead shield child seats) may not prevent the ejection of toddlers from child safety seats during rollovers.