title: Health care utilization in the elderly Mexican population: expenditures and determinants.
abstract: BACKGROUND
  Worldwide population aging has been considered one of the most important demographic phenomena, and is frequently referred as a determinant of health costs and expenditures. These costs are an effect either of the aging process itself (social) or because of the increase that comes with older age (individual).
  
  
  OBJECTIVE
  To analyze health expenditures and its determinants in a sample of Mexican population, for three dimensions acute morbidity, ambulatory care and hospitalization focusing on different age groups, particularly the elderly.
  
  
  METHODS
  A secondary analysis of the Mexican National Health and Nutrition Survey (ENSANUT), 2006 was conducted. A descriptive analysis was performed to establish a health profile by socio-demographic characteristics. Logistic regression models were estimated to determine the relation between acute morbidity, ambulatory care, hospitalization and age group; to establish the determinants of hospitalization among the population 60 years and older; and to determine hospitalization expenditures by age.
  
  
  RESULTS
  Higher proportion of elderly reporting health problems was found. Average expenditures of hospitalization in households were $240.6 am dlls, whereas in households exclusively with elderly the expenditure was $308.9 am dlls, the highest among the considered age groups. The multivariate analysis showed higher probability of being hospitalized among the elderly, but not for risks for acute morbidity and ambulatory care. Among the elderly, older age, being male or living in a city or in a metro area implied a higher probability of hospitalization during the last year, with chronic diseases playing a key role in hospitalization.
  
  
  CONCLUSIONS
  The conditions associated with age, such as chronic diseases, have higher weight than age itself; therefore, they are responsible for the higher expenditures reported. Conclusions point towards a differentiated use and intensity of health services depending on age. The projected increase in hospitalization and health care needs for this group requires immediate attention.
authors: Unidad de Investigación Epidemiológica y en Servicios de Salud, Área de Envejecimiento, Centro Médico Nacional Siglo XXI; Instituto Mexicano del Seguro Social, México, México. carmen.garcia@imss.gob.mx
authors: César
authors: C
authors: González-González
authors: Sergio
authors: S
authors: Sánchez-García
authors: Teresa
authors: T
authors: Juárez-Cedillo
authors: Oscar
authors: O
authors: Rosas-Carrasco
authors: Luis M
authors: LM
authors: Gutiérrez-Robledo
authors: Carmen
authors: C
authors: García-Peña
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D002648:Child; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000191:economics* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult