Seniors see doctor more often

Older baby boomers and senior citizens are making more visits to the doctor’s office than people in their age group did 10 years ago, a new study finds.

Fifty-three percent of patients visiting the doctor in 2001 were over age 45, according to the latest annual report from the Centers for Disease Control and Prevention’s National Ambulatory Medical Care Survey, which looks at medical care provided in doctors’ offices. That number compares with 42 percent 10 years ago.

The number of people over age 45 rose 11 percent during the last decade, but the percentage of doctor visits by that age group rose 26 percent. On average, people age 45 years and older are going to the doctor 17 percent more than people in that age category did in 1992.

“People over 45 are going to the doctor more, and there are more of them,” said Catharine Burt, report author and chief of ambulatory statistics at CDC’s National Center for Health Statistics.

The study comes as Congress is trying to craft a final Medicare prescription drug bill — by melding separate House and Senate versions.

Ms. Burt said the numbers in her report mean that any drug benefit, “sure needs to take into account the fact that there is going to be a lot of utilization — both for prescriptions and for preventive care.”

“It’s going to be tough for everybody to pay for it,” she said.

A CDC press release on the study explained that “seniors and older baby boomers are visiting the doctor more often to manage multiple chronic conditions, obtain newly available drugs and seek preventive care.”

More drugs are being prescribed as well, the report found.

In 2001, 1.3 billion drugs were either prescribed or ordered by doctors for their patients, compared with 922.6 million in 1992.

According to data from the Agency for Healthcare Research and Quality’s Medical Expenditure Panel survey, expenses for outpatient-prescribed medicines increased from $72.3 billion in 1997 to $103 billion in 2000. And expenditures for doctor’s office visits increased by 32 percent for people age 45 and over, between 1996 and 2000, the survey found.

Ms. Burt speculated on a number of reasons why people are visiting the doctor more than 10 years ago. She said the rise of managed care could contribute to it, since doctors in managed-care plans tend to focus on disease management, where a patient may return several times.

People also are increasingly interested in preventive care, like being tested for cancer. The public tends to be more educated about health now, with health Web sites easily accessible, and more direct-to-consumer advertising of prescription drugs, she added.

Ed Haislmaier, a visiting research fellow at the Heritage Foundation’s Center for Health Policy Studies, said it is not surprising that people are going to the doctor more. He said America’s rising health care cost and use are not necessarily a bad sign, because it shows Americans have the luxury of doing things like taking vacations and finding ways to improve their health care.

But Mr. Haislmaier said the key is making sure the health care system delivers the most effective services in the most cost-efficient manner. That is where the Medicare system is sorely lacking, he said, noting that Medicare is, “not an integrated chronic care system,” and people often end up seeing multiple doctors for multiple drugs, without any coordination.

“Nobody’s looking at the big picture,” he said.

The best way to reform the system and hold down costs, he said, is to give people the choice of more comprehensive, integrated, private health care plans. If people choose to stay with traditional Medicare and it is not as cost-efficient as the private plans, then people should have to pay extra, he said.

This is the direction taken by the Republican-sponsored House Medicare prescription drug bill. Senate Democrats oppose this approach and say it will kill the Medicare system by forcing people into the private sector.

Mr. Haislmaier rebutted this claim and said if Medicare is the best option, “then it will hold up in competition.”