Utilization Over Time

Which individuals are most likely to need higher levels of health care over a future period of time–that is a key question many payers would like to find an easy answer to.  “Predictive Modeling” attempts to answer this question and may provide some guidance.  A related question is the extent to which a person’s financial condition affects their care-seeking behavior.  Using data from 2004-2008 from the Health and Retirement survey, researchers attempted to learn more about use of health care over an extended period of time, at least for Americans over age 50.  (AJPH Article)   While older Americans on average have more wealth, they also are beginning to use that wealth for living expenses and older people tend to have higher health spending.  The researchers looked for correlation between financial condition, health and use of physicians, hospitals, outpatient surgery and home health care.  The factor most strongly correlated with use of health care was the person’s health and changes in that health status.  Obviously having multiple conditions led to more utilization.  Interestingly, weight and weight change appeared to have little effect on utilization.  Financial factors such as change in wealth or income appeared to play a more minor role in use of health care resources, although as might be expected, wealthier people have more use of discretionary services and poorer people may have higher use because of a correlation of poverty with poor health.  But some correlations with financial effects ran counter to the expected direction.  Overall, the researchers concluded that health was the predominant driver of health care use.  But their data source limits efforts to understand the complex relationship between health and financial status.