Data from the Manitoba Longitudinal Study on Aging (MLSA) were used to test the hypothesis that self-rated health (SRH) is a predictor of mortality independent of "objective health status" (OHS). Subjects were a random sample of non-institutionalized residents of Manitoba aged 65+ in 1971 (n = 3,128). A single item measure of SRH was obtained during a survey conducted in 1971; a baseline measure of OHS was derived from physician and selfreported conditions and health service utilization data. Occurrence and date of death during the years 1971-1977 were known.Analyses of the data revealed that, controlling for

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Canadian and American analysts commonly find that a small proportion of the elderly is responsible for a large share of health care expenditures. Data on a representative cohort in Manitoba indicate that the longer the time frame studied, the less health care usage concentrates in a single small group of elderly people. Over the sixteen-year period treated, the average older person's risks of using hospital and nursing home services is nevertheless notably higher than reported to date; yet, one-half of the elderly make relatively minimal demands on the health care system. The results reinforce calls for targeting the needs of intensive consumers of health care services and highlight the variability of cumulative usage patterns among older Manitobans.

This research uses data from the Manitoba Longitudinal Study on Aging and multiple logistic regression analysis to assess the impact of twenty-eight sociodemographic and health status variables on nursing home admission. The results indicate that 1) all the short-term predictors continue to be significantly associated with facility bed use in the long run, suggesting that the high risk elderly can be identified relatively early; 2) the key sociodemographic characteristics are better predictors of admission than health and physical functioning characteristics; and 3) time itself appears to change the relationship of the study variables to admission.

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