National Institute for Public Health and the Environment, Centre for Methodology and Information Services, Department of Statistics and Mathematical Modeling, Bilthoven, The Netherlands.
Soc Sci Med. 2012 Jan;74(2):263-72. doi: 10.1016/j.socscimed.2011.10.026. Epub 2011 Dec 6.
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.
在未来几十年中，人们对医疗保健的需求预计将会增加。不仅人口结构变化会导致对医疗保健的总需求增长，人均医疗保健的使用量也会增长。有人认为，医疗保健利用趋势可能因年龄而异。本文旨在展示荷兰不同医疗保健领域在 1981 年至 2009 年间与年龄相关的医疗保健利用趋势。对于医院部门，我们还探讨了这些趋势与医疗技术状况之间的联系。我们使用荷兰健康调查的汇总数据和全国性医院登记册，通过回归分析研究了医疗保健利用概率的年龄特异性趋势。为了确定医疗技术的影响，我们将特定年龄的医院护理概率的增长与医疗专利数量进行回归，同时调整了与人口统计学、健康状况、供应和机构因素相关的混杂因素。研究结果表明，对于大多数医疗保健领域，65 岁及以上年龄组的医疗保健利用概率趋势最高。研究发现，医疗技术的更大进步与住院概率的更高增长显著相关，尤其是在更高年龄组。与年龄相关的趋势将引发人们对医疗保健代际团结可持续性的质疑，因为团结不仅会因人口老龄化而受到压力，而且随着老年和非老年之间的医疗保健利用差距随着时间的推移而扩大，团结可能会面临额外的压力。对于医院护理的利用，医疗技术的进步可能会加速这一过程。
