TABLE 2-3 Health Services Utilization by Age Group, 2005


All Ages

Ages 65-74

Ages 75 and Over

Number of physician office visits per 100 persons




Number of preventive care visits per 100 personsa




Number of injury-related visits per 100 personsa




Number of hospital outpatient visits per 100 persons (not including ED)




Number of ED visits per 100 persons




Number of days of hospital care per 100 persons




Average hospital length of stay

4.8 days

5.3 days

5.7 days

NOTE: Data are for non-institutionalized persons. ED = Emergency Department.

aData are for 2004.

SOURCE: Hing et al., 2006; NCHS, 2007.

neoplasms (i.e., cancer), diabetes, arthropathies and related disorders (i.e., problems with joints), and heart disease (Hing et al., 2006). Older adults frequently made visits to internal and family-medicine physicians, but more than half of their visits were to specialists (NCHS, 2007). Older adults also tend to visit multiple physicians. In 2003 half of Medicare patients visited between two and five different physicians, 21 percent visited six to nine physicians, and 12 percent visited ten or more different physicians (MedPAC, 2006).

Although there are many specialists for which older adults constitute a large percentage of visits (e.g., 35 percent for internal medicine, 30 percent for neurology), older adults account for only 9 percent of visits to psychiatrists (ADGAP, 2007). The stigma associated with seeking mental health services presumably contributes in part to this low utilization, but limited coverage by Medicare for psychiatric services is also a reason (Manderscheid, 2007). Medicare requires a 50 percent copayment for outpatient mental health services as compared with only 20 percent for most other outpatient services.

Older adults also receive a considerable amount of ambulatory care at hospital outpatient departments. Older adults accounted for more than 13 million visits to hospital outpatient departments in 2004, not including visits to emergency departments (EDs); the reasons for these visits were similar to those for visits to office-based physicians (Middleton and Hing, 2006).

Older adults account for a disproportionate share of emergency services. In fact, the rate of use of emergency medical services (EMS) by older adults is more than four times that of younger patients, and older adults account for 38 percent of all EMS responses (Shah et al., 2007). Between 1993 and 2003 ED visits by patients between the ages of 65 and 74 in-

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