Health service utilization among adults aged 50+ across eleven European countries (the SHARE study 2004/5)



The current study aims to examine the use of preventive and other health services among adults aged 50+ in eleven European countries.


The data used were derived from 16,120 adults aged 50+ years participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). Preventive Health Services Utilization score (PHSUs) and Health Care Services Utilization score (HCSUs) were assessed as a composite value from answers to 12 and 16 questions respectively, on a scale ranging from 0 to 100. Estimations were based on a complex study design.


Participants from Central European countries were found to have significantly higher mean PHSU and HCSU scores than their counterparts in Northern and Southern regions, (p < 0.05) and also exhibited a greater gap between the two scores (29.3, 95% CI: 28.6–30.1). Overall mean PHSU score was 39.9 (95% CI: 39.4–40.4) and mean HCSU score 12.4 (95% CI: 12.2–12.7). Women have a higher mean PHSUs and HCSUs (p < 0.001); as age increases, PHSUs falls and HCSUs rises (p < 0.001). Better educated participants appear to have higher mean PHSUs and HCSUs (p < 0.001). In addition, both of the above scores increase in the presence of chronic diseases (p < 0.001).


Strong correlation is seen between comorbidity, increasing age, educational level, and retirement on the one hand, and increased use of health services on the other hand. The use of health services is a major issue with regard to public health policy formulation.

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Fig. 1



Study of Health, Ageing and Retirement in Europe


Preventive Health Services Utilization score


Health Care Services Utilization score

NCDs :

Non-communicable diseases


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Correspondence to Lena Borboudaki.

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Borboudaki, L., Linardakis, M., Markaki, A.M. et al. Health service utilization among adults aged 50+ across eleven European countries (the SHARE study 2004/5). J Public Health (Berl.) (2020).

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  • Preventive health services
  • Health care services utilization
  • Chronic disease
  • SHARE study