Artoisenet Caroline, Deliège Denise
Socio-économie de la santé, Ecole de santé publique Université catholique de Louvain 30, clos Chapelle-aux-Champs, UCL 30-41, 1200 Bruxelles, Belgique.
Cah Sociol Demogr Med. 2007 Apr-Jun;47(2):125-55.
Utilization of health care is a major concern in the debates about public expenditures and the regulation of human health resources. Concerns regarding inappropriate services are regularly mentioned in Belgium. Our study aims at assessing the utilization of health care, with a particular focus on the impact of morbidity, and a possible sub-consumption behaviour. The probability of having had a medical encounter with a general practitioner or with a specialist during the latest year and the probability of a frequency of encounters higher than national average is assessed thanks to logistic regressions. The functional limitations and the chronic conditions (mainly the poly-pathology) are major factors related to patient encounters with medical doctors. In the future, the number of individuals suffering from functional limitations and/or chronic illness will increase due to the ageing of the population. The pressure on health expenditures will increase also if: the frequency of encounters is adequate, as recommended by the "guidelines" for some illnesses and, the frequency of encounters increases due to the evolution of other factors that have been put forward by our logistic regressions. However, any sub-consumptions cannot be simply labeled as additional real needs, because these are also linked to some characteristics of the patients. Consequently, problems of subconsumption cannot be easily solved just by increasing medical supply.
医疗保健的利用是关于公共支出和人类健康资源监管的辩论中的一个主要问题。在比利时，关于不适当服务的担忧经常被提及。我们的研究旨在评估医疗保健的利用情况，特别关注发病率的影响以及可能的消费不足行为。通过逻辑回归评估在最近一年中与全科医生或专科医生进行医疗接触的概率以及接触频率高于全国平均水平的概率。功能限制和慢性病（主要是多病共存）是与患者就医相关的主要因素。未来，由于人口老龄化，功能受限和/或患有慢性病的人数将会增加。如果：按照某些疾病的“指南”建议，接触频率足够；并且由于我们逻辑回归提出的其他因素的演变，接触频率增加，那么医疗支出的压力也会增加。然而，任何消费不足都不能简单地被视为额外的实际需求，因为这些也与患者的某些特征有关。因此，消费不足问题不能仅仅通过增加医疗供应来轻易解决。
