Patients 45 and older form growing basis of doctors' practices

Men and women 45 and older are increasingly the core patient base for all physicians, a result of baby boomers getting older and sicker. But these patients are more likely to visit specialists than this age group did in the past, according to a data brief issued by the National Center for Health Statistics.

Researchers analyzed data from the U.S. Census and the National Ambulatory Medical Care Survey to assemble the brief, which was released Aug. 6.

Researchers found that those 45 and older made up 33% of the U.S. population in 1998 but 38% in 2008. About 49% of doctor's office visits were focused on providing care for this group in 1998, compared with 57% in 2008. The group was prescribed 60% of medications given to patients during visits in 1998, compared with 70% in 2008.

It's unclear what impact the recession has had on these trends, but the authors said the numbers are being driven in large part by the aging of baby boomers. The Census Bureau defines baby boomers as those born between 1945 and 1964; currently 46 to 65 years old.

But other factors are at work. Researchers suspect that the obesity epidemic means that some conditions are becoming more common for these patients. In addition, technological improvements make it more possible to care for many issues in an outpatient setting that previously were cared for on an inpatient basis or not at all. For instance, visits for treatment of lipid disorders increased 150% and those for cardiac dysrhythmias went up 139%.

"The baby boomers are aging and bringing with them more chronic conditions and a greater need for physician services," said Donald Cherry, the brief's lead author and an NCHS statistician.

Care for people 65 and older also moved more to the specialty setting. In 1978, 37% of office visits by this age group were to specialists, with 62% of services provided by primary care physicians. The numbers shifted in 2008, with 55% of office visits in the specialty setting and 45% in primary care. These trends were similar in patients 45 to 64. In this latter group, 61% of visits were to primary care physicians in 1978, compared with 53% in 2008.

The data brief's authors suspect these phenomena may be connected to a shortage of primary care physicians, meaning that specialty care may be more accessible in some situations (link).