Compression or expansion of morbidity in outpatient healthcare?. Generation 65plus in 2007 and 2014

Background. The ageing population raises the question whether there is a compression or expansion of morbidity. Objective. This study examined the development of morbidity and the associated outpatient volume of services in outpatient healthcare. Material and methods. With a nationwide sample of statutory health insurance patients, the development of the documented morbidity and outpatient volume of services of the generation 65plus was empirically examined by a retrospective, cohort- specific study based on outpatient claims data covering the years 2007 and 2014. Results. In 2014 the proportion of multimorbid patients was increased compared to chronically ill patients, other users and nonusers. A subgroup analysis showed declining incidences for nearly all age and gender groups. In total, the average outpatient volume of services per patient increased, which is primarily attributable to increasing care of multimorbid and deceased patients. Conclusion. High life expectancy leads to a susceptibility for chronic diseases and multimorbidity, which indicates an expansion of morbidity in outpatient care. The resulting increased need for outpatient care should be covered with specific healthcare concepts for chronically ill and multimorbid patients. Declining incidences are a positive indication to reinforce health- promoting measures for the generation 65plus. To develop specific healthcare offers for a heterogeneous generation 65plus, a differentiated analysis for example by socioeconomic status and disease patterns is needed.