Comparisons of annual health care utilization, drug consumption, and medical expenditure between the elderly and general population in Taiwan

Abstract

Background/Purpose

The aim of this study was to present an overview of health care utilization (outpatient, inpatient, and emergency visits), total medical expenditure, and drug consumption between the elderly and general population under Taiwan's National Health Insurance program.

Methods

We conducted a cross-sectional analysis using the 2010 Taiwan's Longitudinal Health Insurance Database. Our analysis included 999,418 beneficiaries with eligible records under the National Health Insurance system. Among them, 10.43% (n = 104,273) were elderly (65 years and older). Health care utilization [including outpatient, emergency department (ED), and inpatient visits], medical expenditure, as well as drug consumption for the entire study cohort (“the general population”) and the elderly were estimated using patient-level data from the Longitudinal Health Insurance Database. Specifically, “polypharmacy” and “excessive polypharmacy” defined as the concomitant use of five or more drugs and 10 or more drugs, respectively, were used to quantify drug consumption.

Results

The annual use of outpatient visits [mean (standard deviation): elderly 26.7 (21.5) vs. 12.2 (14.5)] per elderly individual doubled that of the general population. Approximately one-in-five of the elderly were admitted to hospital (20.9%) and went to ED (22.6%) at least once annually. Only 7.7% and 14.0% of the general public were admitted to hospital and went to ER at least once annually. The elderly had higher drug consumption and were more likely to be users of polypharmacy than the general population (elderly 15.5% vs. 3.7%). The annual medical expenditure per elderly individual tripled that of the general population (elderly 1846 US$ vs. 554 US$).

Conclusion

Elderly people had higher medical utilization than the general population, which may contribute to a fragmented health care system. Strategies to integrate health care for older people would be considered a first priority task of policymakers and health professionals.