title: [In Process Citation].
abstract: OBJECTIVE
  The influence of the demographic change and the impact on the entire health care system have been discussed by different theories (Expansion of Morbidity, Compression of Morbidity, Bimodality of Morbidity). This paper aims to project for the outpatient health care of statutory health insurance, the influence of the demographic development, the size and structure of statutory health insured and the change in morbidity based utilization on the outpatient volume of services for 2020.
  
  
  METHODS
  Considered impact factors and their trend specifications are separately modelled and modular combined as components of scenarios.
  
  
  RESULTS
  The compound annual growth rate of the outpatient volume of services varies between almost 0 and 2.2%.
  
  
  CONCLUSIONS
  For 2020 a moderate increase of outpatient volume of services for statutory health insurance is expected, if costs of dying are taken into account, even though cross-sectional data for 2011 show a decrease in expenditure profiles with increased age. Projections with the scenario technique can support strategic decision making by estimating likely trends and effects of measures given the causal process in health care systems.
authors.affiliation: Kassenärztliche Bundesvereinigung, Berlin.
authors.forename: J
authors.initials: J
authors.lastname: Frank
authors.affiliation: Kassenärztliche Bundesvereinigung, Berlin.
authors.forename: A
authors.initials: A
authors.lastname: Ryll
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends*; D003198:Computer Simulation; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data / Q000639:trends; D015233:Models, Statistical; D009017:Morbidity / Q000639:trends*; D009313:National Health Programs / Q000706:statistics & numerical data* / Q000639:trends; D010045:Outpatients / Q000706:statistics & numerical data*; D011157:Population Dynamics / Q000706:statistics & numerical data / Q000639:trends*; D014600:Utilization Review