Older baby boomers sicker, using more care than earlier generations

The oldest end of the baby boom generation, people now age 55 to 64, is consuming health care in greater amounts than same-aged individuals did in prior generations, according to a March report by the Centers for Disease Control and Prevention's National Center for Health Statistics.

"It's an interesting age group because they are the next one eligible for Medicare services," said Virginia Freid, the paper's lead author and an NCHS statistician. "This presents a real concern for Medicare in the future."

Researchers analyzed numbers from the National Hospital Discharge Survey, the National Ambulatory Medical Care Survey and other large government databases. Individuals in the 55 to 64 age group had 433.3 physician or outpatient visits per hundred people in 2006, but only 385.0 per hundred in 1996, an increase of 13%. Numbers also grew for emergency department and ambulatory surgical care.

Data reflecting the impact of the recession are not available, but many experts suspect the economic downturn may have led some 55- to 64-year-olds to make cutbacks on health care. But those cutbacks are most likely to be minimal since many from this age group have chronic conditions for which they cannot forgo treatments.

"It would actually surprise me if [the recession] did have a significant impact on demand for health care services in this age group," said Jay Bhattacharya, MD, PhD, associate professor of medicine at Stanford University School of Medicine's Center for Primary Care and Outcomes Research in Calif. "You have to get taken care of whether there is a recession or not."

Several studies have suggested that this age group has a higher rate of impairment than did prior generations. One study, published in the April Health Affairs, reported that people age 50 to 64 were more likely to need help with personal care activities because of musculoskeletal conditions, depression, diabetes or nervous system problems.

Another study, published in the January American Journal of Public Health, found no increase in impairments among people age 70 to 79 but did find an increase among those age 60 to 69.

Older boomers can get the care they need in part because they have lower uninsured rates than do other age groups. According to the Census Bureau, 12.5% of the 55 to 64 age group was uninsured in 2008, in contrast with 19.4% of those age 35 to 44.

Advances in medicine and technology have been providing more access to and information about drugs, tests, imaging procedures and surgeries. For instance, for the 55 to 64 age group, the percentage of doctor visits where some form of advanced imaging scan was ordered doubled to 4% from 1996 to 2006, according to the CDC. The proportion of hospital ED visits involving this type of scanning more than tripled to 16% during the same period. And the percentage of visits with at least five drugs prescribed more than doubled to 25%.

"People are more aware of what is available with the Internet and they go in asking for certain drugs or certain types of scans," said Freid.

Care also is shifting to the outpatient setting. The rate of inpatient hospital discharges was essentially unchanged, and the length of stay decreased, according to the CDC. This reflects an increasing use of ambulatory care and explains in part recent hospital financial troubles, experts said, although some procedures in inpatient settings did increase. For example, the 55 to 64 age group had significantly more coronary artery stent insertions and total knee and hip replacements. But this is most likely linked to an increase in obesity, experts said.

Inpatient procedures declining in number included cholecystectomy, which has largely become an outpatient procedure, and coronary artery bypass, which is gradually being replaced with other heart procedures, experts said.