title: Medical innovation and age-specific trends in health care utilization: findings and implications.
abstract: Health care utilization is expected to rise in the coming decades. Not only will the aggregate need for health care grow by changing demographics, so too will per capita utilization. It has been suggested that trends in health care utilization may be age-specific. In this paper, age-specific trends in health care utilization are presented for different health care sectors in the Netherlands, for the period 1981-2009. For the hospital sector we also explore the link between these trends and the state of medical technology. Using aggregated data from a Dutch health survey and a nationwide hospital register, regression analysis was used to examine age-specific trends in the probability of utilizing health care. To determine the influence of medical technology, the growth in age-specific probabilities of hospital care was regressed on the number of medical patents while adjusting for confounders related to demographics, health status, supply and institutional factors. The findings suggest that for most health care sectors, the trend in the probability of health care utilization is highest for ages 65 and up. Larger advances in medical technology are found to be significantly associated with a higher growth of hospitalization probability, particularly for the higher ages. Age-specific trends will raise questions on the sustainability of intergenerational solidarity in health care, as solidarity will not only be strained by the ageing population, but also might find itself under additional pressure as the gap in health care utilization between elderly and non-elderly grows over time. For hospital care utilization, this process might well be accelerated by advances in medical technology.
authors.affiliation: National Institute for Public Health and the Environment, Centre for Methodology and Information Services, Department of Statistics and Mathematical Modeling, Bilthoven, The Netherlands. albert.wong@rivm.nl
authors.forename: Albert
authors.initials: A
authors.lastname: Wong
authors.forename: Bram
authors.initials: B
authors.lastname: Wouterse
authors.forename: Laurentius C J
authors.initials: LC
authors.lastname: Slobbe
authors.forename: Hendriek C
authors.initials: HC
authors.lastname: Boshuizen
authors.forename: Johan J
authors.initials: JJ
authors.lastname: Polder
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000375:Aging; D020811:Biomedical Technology / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010330:Patents as Topic / Q000706:statistics & numerical data; D017678:Sex Distribution