HEALTH-SERVICES AND THE ELDERLY - AN EVALUATION OF UTILIZATION DATA

Medical and diagnostic services for people aged 65 and over comprise a substantial proportion of all services provided by the Health insuran ce Commission under the Medicare Benefits Schedule. To examine the uti lisation of these services by people in this age group, we analysed de -identified data on a cohort of people who claimed for at least one su ch service in NSW in 1991. The fetal number of services claimed for by this cohort of 7,724 people was 144,658. The median number of service s received by individuals during the year was 13.5 per person for the cohort (or 9.9 for the total group). Of the total services reimbursed, 64.7% were for doctors' consultations, 24.8% were for diagnostic serv ices and 10.6% were for other services, predominantly operations. The most common claims were for visits to a general practitioner for a sta ndard consultation. Service utilisation differed between the age and s ex categories of the patients in the study sample. Utilisation tended to increase with age and was more common among women than men for seve ral of the service groups considered. We report the results of these a nalyses and discuss the potential benefits and disadvantages of using claims data to evaluate utilisation of medical and diagnostic services , and current clinical practices.