Patterns and determinants of health care utilisation in Ireland

Hdl Handle:
http://hdl.handle.net/10147/301630
Title:
Patterns and determinants of health care utilisation in Ireland
Authors:
McNamara, Aoife; Normand, Charles; Whelan, Brendan
Publisher:
The Irish Longitudinal Study on Ageing (TILDA)
Issue Date:
Feb-2013
URI:
http://hdl.handle.net/10147/301630
Additional Links:
http://www.tcd.ie/tilda/assets/pdf/Tilda%20Health%20Care%20Utilisation%20Report.pdf
Item Type:
Report
Language:
en
Description:
In Ireland health care utilisation depends on many factors that relate both to the health care system and to the characteristics of individual patients. In a time of social and economic transition, characterised by increased life expectancy, population ageing, changing expectations and the re-structuring of health services, it is crucial to disentangle the complex patterns and drivers of health service utilisation. This will help us understand the future demand for health care services, and better assess the potential impact of an ageing population. The data comes from the first wave of The Irish Longitudinal Study on Ageing TILDA (Barrett A 2011), a prospective study of 8,175 participants representative of the community-living population aged 50 and over in Ireland. In particular, we look at the relationship between age and other possible drivers of the intensity of service utilisation in hospital, primary, community and social care services. We use a number of self-reported health measures (overall health, emotional and mental health, chronic conditions and limitations in daily activities) to highlight the key drivers of health care utilisation, and to characterise the most frequent service users. Ireland has a complex set of entitlements to health care. At the time of the survey almost 70% of the population were paying out of pocket costs for primary and secondary care services. About 30% of the population had medical cards, providing free access to these services. We look at entitlement status such as those with private health insurance, medical card holders and those with no (additional) health coverage to examine the effect of different prices faced by service users and their impact on use of services. In line with previous work, this research highlights the differential utilisation rates between medical card holders and non-medical card holders (Nolan and Nolan 2004; Nolan 2007; Nolan and Nolan 2008; Nolan and Smith 2012) indicating that the price faced by users is a strong determinant of health care utilisation. Using TILDA’s rich range of self-reported health measures we found that age in itself is not a significant driver of health care utilisation, the key drivers being entitlement status, poor self-rated health, limitations in daily activities and the presence of one or more chronic conditions. However, different patterns arise in the case of community and social care services with age being a major driver of utilisation.
Keywords:
AGEING; HEALTH SERVICES; OLDER PEOPLE
ISSN:
9781907894053

Full metadata record

DC FieldValue Language
dc.contributor.authorMcNamara, Aoifeen_GB
dc.contributor.authorNormand, Charlesen_GB
dc.contributor.authorWhelan, Brendanen_GB
dc.date.accessioned2013-09-16T14:06:44Z-
dc.date.available2013-09-16T14:06:44Z-
dc.date.issued2013-02-
dc.identifier.issn9781907894053-
dc.identifier.urihttp://hdl.handle.net/10147/301630-
dc.descriptionIn Ireland health care utilisation depends on many factors that relate both to the health care system and to the characteristics of individual patients. In a time of social and economic transition, characterised by increased life expectancy, population ageing, changing expectations and the re-structuring of health services, it is crucial to disentangle the complex patterns and drivers of health service utilisation. This will help us understand the future demand for health care services, and better assess the potential impact of an ageing population. The data comes from the first wave of The Irish Longitudinal Study on Ageing TILDA (Barrett A 2011), a prospective study of 8,175 participants representative of the community-living population aged 50 and over in Ireland. In particular, we look at the relationship between age and other possible drivers of the intensity of service utilisation in hospital, primary, community and social care services. We use a number of self-reported health measures (overall health, emotional and mental health, chronic conditions and limitations in daily activities) to highlight the key drivers of health care utilisation, and to characterise the most frequent service users. Ireland has a complex set of entitlements to health care. At the time of the survey almost 70% of the population were paying out of pocket costs for primary and secondary care services. About 30% of the population had medical cards, providing free access to these services. We look at entitlement status such as those with private health insurance, medical card holders and those with no (additional) health coverage to examine the effect of different prices faced by service users and their impact on use of services. In line with previous work, this research highlights the differential utilisation rates between medical card holders and non-medical card holders (Nolan and Nolan 2004; Nolan 2007; Nolan and Nolan 2008; Nolan and Smith 2012) indicating that the price faced by users is a strong determinant of health care utilisation. Using TILDA’s rich range of self-reported health measures we found that age in itself is not a significant driver of health care utilisation, the key drivers being entitlement status, poor self-rated health, limitations in daily activities and the presence of one or more chronic conditions. However, different patterns arise in the case of community and social care services with age being a major driver of utilisation.en_GB
dc.language.isoenen
dc.publisherThe Irish Longitudinal Study on Ageing (TILDA)en_GB
dc.relation.urlhttp://www.tcd.ie/tilda/assets/pdf/Tilda%20Health%20Care%20Utilisation%20Report.pdfen_GB
dc.subjectAGEINGen_GB
dc.subjectHEALTH SERVICESen_GB
dc.subjectOLDER PEOPLEen_GB
dc.titlePatterns and determinants of health care utilisation in Irelanden_GB
dc.typeReporten
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