title: Has the prevalence of health care services use increased over the last decade (2001-2009) in elderly people? A Spanish population-based survey.
abstract: OBJECTIVE
  (1) To describe the prevalence of general practitioner visits and hospitalization according to sex and age groups; (2) to identify which factors are independently associated with a higher use of health care services among elderly Spanish; and (3) to study the time trends in the prevalence of use of health care services 2001-2009.
  
  
  METHODS
  Observational study. We analyzed data from the Spanish National Health Surveys conducted in 2001 (n=21,058), 2003 (n=21,650), 2006 (n=29,478) and 2009 (n=22,188). We included responses from adults aged 65 years and older.
  
  
  METHODS
  The main variables were the number of general practitioner visits in the last 4 weeks and hospitalization in the past year. We stratified the adjusted models by the main variables. We analyzed socio-demographic characteristics, health related variables, using multivariate logistic regression models.
  
  
  RESULTS
  The total number of subjects was 24,349 (15,041 woman, 9309 men). Women were significantly older than men (P<0.001). Women had higher prevalence of general practitioner visits than men in all surveys. Men had significantly higher prevalence of hospitalizations than women in the years 2001, 2006 and 2009. When we adjusted the hospitalization by possible confounders using logistic regressions, men had a higher probability of being hospitalized than women (OR 1.53, 1.39-1.69). The variables that were significantly associated with a higher use of health care services were lower educational level, worse self-rated health, chronic conditions, polypharmacy, and the level of disability. The number of general practitioner visits among women and men significantly increased from 2001 to 2009 (women: OR 1.43, 1.27-1.61; men: OR 1.71, 1.49-1.97).
  
  
  CONCLUSIONS
  The current study revealed an increase in health care services utilization from 2001 to 2009 in the older Spanish population.
authors: Department of Health Sciences, Universidad Rey Juan Carlos, Avenida Atenas s/n, 28922 Alcorcon, Madrid, Spain. Electronic address: domingo.palacios@urjc.es.
authors: Domingo
authors: D
authors: Palacios-Ceña
authors: Valentín
authors: V
authors: Hernández-Barrera
authors: Rodrigo
authors: R
authors: Jiménez-García
authors: Begoña
authors: B
authors: Valle-Martín
authors: César
authors: C
authors: Fernández-de-las-Peñas
authors: Pilar
authors: P
authors: Carrasco-Garrido
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data* / Q000639:trends; D006304:Health Status; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data* / Q000639:trends; D010342:Patient Acceptance of Health Care; D019338:Polypharmacy; D015995:Prevalence; D057566:Self Report; D012959:Socioeconomic Factors; D013030:Spain
keywords: Health care services; Older people; Population-based; Survey; Time trends