Skip to main content
SpringerLink
Log in

Future outpatient health-care utilisation in an ageing population: projections up to the year 2020 based on the Study of Health in Pomerania (SHIP)

  • Original Article
  • Published:
Journal of Public Health Aims and scope Submit manuscript

Abstract

Aim

The population in the German federal state of Mecklenburg-West Pomerania is growing older. The resulting increase in the incidence of age-related diseases will lead to a higher demand for medical care although the population is declining. The aim of the study was to project the future outpatient health-care utilisation.

Subjects and methods

Representative data on health-care utilisation were derived from the Study of Health in Pomerania (SHIP). Participants (n = 3,292, age 25–84 years) were asked whether they had consulted a physician in the past year and if so, the type of physician and the total number of visits. These data were combined with demographic forecasts for Mecklenburg-West Pomerania and its rural and urban districts up to the year 2020 to project the number of patients and their number of consultations with general practitioners and specialists in outpatient care.

Results

The projected number of annual consultations will increase in 2020 as compared to 2008 for urologists (+14.5 %), internists (+11.2 %), ophthalmologists (+7.7 %), neurologists (+6.0 %) and general practitioners (+5.8 %). In contrast, visits to gynaecologists will decrease until 2020 (−10.8 %). The predicted changes in the number of consultations show considerable heterogeneity between the districts.

Conclusion

Physicians who are consulted mainly by senior patients will face a higher number of consultations in 2020. Similar developments will probably occur in other German federal states and other industrialised countries in which demographic transition is already evident. These changes have to be considered in a rational planning of future medical-care provision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Bergmann E, Kamtsiuris P (1999) Inanspruchnahme medizinischer Leistungen [Medical services utilisation]. Gesundheitswesen (Sonderheft 2):138–144

  • Bergmann E, Kalcklösch M, Tiemann F (2005) Inanspruchnahme des Gesundheitswesens: Erste Ergebnisse des telefonischen Gesundheitssurveys 2003 [Public health-care utilisation: initial results of the Telephone Health Survey 2003]. Bundesgesundheitsblatt 48(12):1365–1373

    Article  CAS  Google Scholar 

  • Bhandari A, Wagner T (2006) Self-reported utilization of health care services: improving measurement and accuracy. Med Care Res Rev 63:217–235. doi:10.1177/1077558705285298

    Article  PubMed  Google Scholar 

  • Braun GE, Schumann A (2007) Perspektiven der ambulant ärztlichen Versorgung vor dem Hintergrund des demographischen Wandels [Perspectives of outpatient medical care in the context of demographic change]. In: Bräunig D, Greiling D (eds) Stand und Perspektiven der Öffentlichen Betriebswirtschaftslehre II. Wissenschafts-Verlag, Berlin, pp 184–200

    Google Scholar 

  • Bureau of Health Professions (2008) The physician workforce: projections and research into current issues affecting supply and demand. U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Washington, DC. ftp://ftp.hrsa.gov/bhpr/workforce/physicianworkforce.pdf. Accessed 10 January 2012

  • Center for Workforce Studies (2008) The complexities of physician supply and demand: projections through 2025. Association of American Medical Colleges (AAMC), Washington, DC. http://www.tht.org/education/resources/AAMC.pdf. Accessed 10 January 2012

  • Center for Workforce Studies (2010) Recent studies and reports on physician shortages in the U.S. Association of American Medical Colleges (AAMC), Washington, DC. https://www.aamc.org/download/100598/data/recentworkforcestudiesnov09.pdf. Accessed 10 January 2012

  • Cleary PD, Jette AM (1984) The validity of self-reported physician utilization measures. Med Care 22:796–803

    Article  PubMed  CAS  Google Scholar 

  • de Boer AG, Wijker W, de Haes HC (1997) Predictors of health care utilization in the chronically ill: a review of the literature. Health Policy 42(2):101–115. doi:10.1016/S0168-8510(97)00062-6

    Article  PubMed  Google Scholar 

  • Statistische Ämter des Bundes und der Länder (2008) Demografischer Wandel in Deutschland: Auswirkungen auf Krankenhausbehandlungen und Pflegebedürftige im Bund und in den Ländern [Demographic change in Germany: consequences for hospital care and long-term care in the federal states and the German federation]. Statistische Ämter, Wiesbaden, Germany. http://www.statistik-portal.de/Statistik-Portal/demografischer_wandel_heft2.pdf. Accessed 10 January 2012

  • Fendrich K, Hoffmann W (2007) More than just aging societies: the demographic change has an impact on actual numbers of patients. J Public Health 15:345–351. doi:10.1007/s10389-007-0142-0

    Article  Google Scholar 

  • Foerch C, Misselwitz B, Sitzer M, Steinmetz H, Neumann-Haefelin T (2008) The projected burden of stroke in the German federal state of Hesse up to the year 2050. Dtsch Arztebl Int 105(26):467–473. doi:10.3238/arztebl.2008.0467

    PubMed  Google Scholar 

  • Hessel A, Gunzelmann T, Geyer M, Brahler E (2000) Inanspruchnahme medizinischer Leistungen und Medikamenteneinnahme bei über 60jährigen in Deutschland: gesundheitliche, sozialstrukturelle, sozio-demographische und subjektive Faktoren [Utilisation of medical services and medication intake of patients over 60 in Germany: health related, social structure related, socio-demographic and subjective factors]. Z Gerontol Geriatr 33(4):289–299

    Article  PubMed  CAS  Google Scholar 

  • Katalinic A, Peters E, Beske F, Pritzkuleit R (2010) Projection of morbidity 2030 and 2050: impact for the national health system and blood supply. Transfus Med Hemother 37:155–159. doi:10.1159/000313993

    Article  PubMed  Google Scholar 

  • Gemeinsamer Bundesausschuss der Ärzte und Krankenkassen (2010) Richtlinie des Gemeinsamen Bundesausschusses über die Bedarfsplanung sowie die Maßstäbe zur Feststellung von Überversorgung und Unterversorgung in der vertragsärztlichen Versorgung (Bedarfsplanungs-Richtlinie) [Guideline of the Federal Joint Committee about health-care planning and criteria to assess under- and over-supply in outpatient health care]. Gemeinsamer Bundesausschuss, Berlin. http://www.g-ba.de/downloads/62-492-468/RL_Bedarf_2010-07-15.pdf. Accessed 10 January 2012

  • Oeppen J, Vaupel JW (2002) Broken limits to life expectancy. Science 296(5570):1029–1031. doi:10.1126/science.1069675

    Article  PubMed  CAS  Google Scholar 

  • Phillips KA, Morrison KR, Andersen R, Aday LA (1998) Understanding the context of healthcare utilization: assessing environmental and provider-related variables in the behavioral model of utilization. Health Serv Res 33(3):571–596, Pt 1

    PubMed  CAS  Google Scholar 

  • Pritzkuleit R, Beske F, Katalinic A (2010) Demographischer Wandel und Krebserkrankungen in der Zukunft [Demographic change and cancer]. Onkologie 33(Suppl 7):19–24. doi:10.1159/000319738

    Article  PubMed  Google Scholar 

  • Ritter PL, Stewart AL, Kaymaz H et al (2001) Self-reports of health care utilization compared to provider records. J Clin Epidemiol 54:136–141. doi:10.1016/S0895-4356(00)00261-4

    Article  PubMed  CAS  Google Scholar 

  • Schallock M, Czihal T, Graf von Stillfried D (2009) Zukünftige vertragsärztliche Versorgung in dünn besiedelten ländlichen Räumen Thüringens: Eine kleinräumige Analyse zum Jahr 2020—Gutachten [Future outpatient care in sparsely populated rural areas in Thuringia: a small-scale analysis of the year 2020—report]. Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland, Berlin. http://www.zi-berlin.de/cms/fileadmin/images/content/PDFs_alle/Gutachten_KVThueringen_kleinraeumigeAnalyse.pdf. Accessed 10 January 2012

  • Scholz RD, Rößger F, Kreft D, Steinberg J, Doblhammer-Reiter G (2010) Bevölkerungsprognose für Mecklenburg-Vorpommern auf Kreisebene bis zum Jahr 2030 [Population forecast for the administrative districts of Mecklenburg-West Pomerania up to the year 2030]. In: GESIS-IZ Sozialwissenschaften soFid Bevölkerungsforschung 2010/1. Bonn, pp 9–38. http://www.gesis.org/fileadmin/upload/dienstleistung/fachinformationen/servicepublikationen/sofid/Fachbeitraege/Bevoelkerung_10-1_FB.pdf?download=true. Accessed 10 January 2012

  • Schulz E, Leidl R, Konig HH (2004) The impact of ageing on hospital care and long-term care: the example of Germany. Health Policy 67:57–74. doi:10.1016/S0168-8510(03)00083-6

    Article  PubMed  Google Scholar 

  • Siewert U, Fendrich K, Doblhammer-Reiter G et al (2010) Health care consequences of demographic changes in Mecklenburg-West Pomerania: projected case numbers for age-related diseases up to the year 2020, based on the Study of Health in Pomerania (SHIP). Dtsch Arztebl Int 107(18):328–334. doi:10.3238/arztebl.2010.0328

    PubMed  Google Scholar 

  • Statistisches Amt Mecklenburg-Vorpommern (2007) Statistische Berichte: 3. Landesprognose (Basisjahr 2005): Bevölkerungsentwicklung in Mecklenburg-Vorpommern bis 2020—überarbeitete Fassung 2007 [Statistical reports: third forecast for the federal state (base year 2005): population development in Mecklenburg-West Pomerania until 2020, revision 2007]. Statistisches Amt, Schwerin, Germany. http://service.mvnet.de/statmv/daten_stam_berichte/e-bibointerth01/bevoelkerung--haushalte--familien--flaeche/a-i__/a183l__/daten/a183l-2007-01.pdf. Accessed 10 January 2012

  • Statistisches Amt Mecklenburg-Vorpommern (2009) Statistische Berichte: Bevölkerung nach Alter und Geschlecht in Mecklenburg-Vorpommern 2008, Teil 1: Kreisergebnisse [Statistical reports: age- and sex-specific population in Mecklenburg-West Pomerania in 2008, part 1: administrative districts]. Statistisches Amt, Schwerin, Germany. http://service.mvnet.de/statmv/daten_stam_berichte/e-bibointerth01/bevoelkerung--haushalte--familien--flaeche/a-i__/a133k__/2008/daten/a133k-2008-00.pdf Accessed 10 January 2012

  • Statistisches Amt Mecklenburg-Vorpommern (2011) Statistisches Jahrbuch Mecklenburg-Vorpommern 2011 [Statistical yearbook of Mecklenburg-West Pomerania 2011]. Statistisches Amt, Schwerin, Germany. http://www.statistikmv.de/cms2/STAM_prod/STAM/_downloads/Veroeffentlichungen/7._Gesamtausgabe(2010).pdf. Accessed 20 July 2012

  • Thode N, Bergmann E, Kamtsiuris P, Kurth BM (2005) Einflussfaktoren auf die ambulante Inanspruchnahme in Deutschland [Predictors for ambulatory medical-care utilisation in Germany]. Bundesgesundheitsblatt 48(3):296–306

    Article  CAS  Google Scholar 

  • United Nations (2005) World population prospects: the 2004 revision— highlights. United Nations, New York. http://www.un.org/esa/population/publications/WPP2004/2004Highlights_finalrevised.pdf. Accessed 10 January 2012

  • Vaupel JW, Carey JR, Christensen K (1998) Biodemographic trajectories of longevity. Science 280:855–860. doi:10.1126/science.280.5365.855

    Article  PubMed  CAS  Google Scholar 

  • Völzke H, Alte D, Schmidt CO et al (2011) Cohort profile: the Study of Health in Pomerania. Int J Epidemiol 40:294–307. doi:10.1093/ije/dyp394

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Prof. Kurth for expert advice and for acting as the godmother of the project. This study was financially supported by the German Medical Association as part of the first funding phase of the Funding Initiative on Health Services Research. Grant No. 06-34/79. SHIP is part of the Community Medicine Research Net of the University of Greifswald (available at http://www.medizin.uni-greifswald.de/cm) and was funded by grant ZZ9603 from the Federal Ministry of Education and Research, Berlin, and the Ministers of Cultural and Social Affairs of the Federal State of Mecklenburg-West Pomerania, Schwerin.

Conflict of interest statement

The authors declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.

Author information

Authors and Affiliations

  1. Institute for Community Medicine, Department of Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1–2, 17487, Greifswald, Germany

    Ulrike Siewert, Konstanze Fendrich & Wolfgang Hoffmann

  2. Institute for Community Medicine, Department of Study of Health in Pomerania – Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany

    Marcello Ricardo Paulista Markus & Sebastian E. Baumeister

  3. Rostock Center for the Study of Demographic change, Rostock, Germany

    Gabriele Doblhammer-Reiter & Rembrandt D. Scholz

  4. German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany

    Wolfgang Hoffmann

Authors
  1. Ulrike Siewert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Konstanze Fendrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcello Ricardo Paulista Markus
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sebastian E. Baumeister
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gabriele Doblhammer-Reiter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rembrandt D. Scholz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wolfgang Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrike Siewert.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

Data sources for the projection of health-care utilisation. Consultation rate: percentage of participants with at least one consultation. (JPEG 31 kb)

High Resolution (TIFF 16 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siewert, U., Fendrich, K., Markus, M.R.P. et al. Future outpatient health-care utilisation in an ageing population: projections up to the year 2020 based on the Study of Health in Pomerania (SHIP). J Public Health 21, 289–296 (2013). https://doi.org/10.1007/s10389-012-0550-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10389-012-0550-7

Keywords

Search

Navigation