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Little
Change in Healthcare Use in 40 Years
NEW
YORK (Reuters Health) - Despite tremendous upheaval in the financing
and delivery of healthcare in the US, Americans' use of health
services has changed little since John F. Kennedy was president,
a new study finds.
Each month,
an estimated 800 of every 1,000 American men, women and children
experience health-related symptoms, according to national survey
data. Of these, 217 visit a physician, 13 visit an emergency room
and eight are hospitalized, researchers report in the June 28th
issue of The New England Journal of Medicine.
``That certainly
surprised us,'' said study co-author Dr. David Lanier of the Agency
for Healthcare Research and Quality in Rockville, Maryland. ``We
expected huge changes when we first began the study.''
The report
updates a 1961 study of the ``ecology'' of healthcare. The original
study estimated that in a population of 1,000 adults, 750 reported
an illness each month, 250 consulted a physician and nine were
hospitalized.
Why so little
change? The authors suggest that people's use of healthcare services
depends more on their own preferences than on changes in the way
healthcare system is organized.
Another possibility
is that various developments in healthcare have offset increased
use. ``For example,'' they write, ``an increase in the proportion
of older persons with chronic disease may have resulted in more
office visits and hospital stays, but cost containment by hospitals
and the shifting of care to outpatient departments and patients'
homes may have moderated these effects.''
The study
indicates that, despite the tremendous changes in healthcare delivery
since 1961, basic human nature about whether to seek care and
where to seek it has not changed that much, Lanier said in an
interview.
One slight
change is the proliferation of healthcare settings. The study
found that 65 out of 1,000 people visited a complementary or alternative
care provider each month, and 14 received home healthcare services.
SOURCE:
The New England Journal of Medicine 2001;344:2021-2025.
Reference
Source 89
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