Chile: Effects of Old Age on Health Services Utilization and Consequences on System Design

This paper analyzes the relationship between age and health services utilization in Chile, using the CASEN survey of 1994. Logistic analysis is performed to determine how age utilization profiles differ by income, location and system affiliation (private or public insurance). The results are used to discuss the consequences of population aging on the health system, detect problems and suggest possible solutions. In Chile, older persons have both a higher probability of being ill, and a higher probability of seeking care if they are ill. Expected utilization is more than three times higher for older persons than for persons 18-34 years old. Most old people currently are affiliates of the public health system. Hence the aging of the population could be expected to be mainly a problem for the public sector. However, this would be so only if the pricing system of both the private and public insurance systems is not reformed. Moreover, without such a change, a large injection of funds into the public sector could result in an unexpected shift of affiliates from the public and into the private sector, generating under capacity in the public sector and over capacity in the private sector.