La consommation de soins médicaux et les comportements de sous-consommation en Belgique et à l'étranger.

Utilization of health care is a major concern in the debates about public expenditures and the regulation of human health resources. Concerns regarding inappropriate services are regularly mentioned in Belgium. Our study aims at assessing the utilization of health care, with a particular focus on the impact of morbidity, and a possible sub-consumption behaviour. The probability of having had a medical encounter with a general practitioner or with a specialist during the latest year and the probability of a frequency of encounters higher than national average is assessed thanks to logistic regressions. The functional limitations and the chronic conditions (mainly the poly-pathology) are major factors related to patient encounters with medical doctors. In the future, the number of individuals suffering from functional limitations and/or chronic illness will increase due to the ageing of the population. The pressure on health expenditures will increase also if: the frequency of encounters is adequate, as recommended by the "guidelines" for some illnesses and, the frequency of encounters increases due to the evolution of other factors that have been put forward by our logistic regressions. However, any sub-consumptions cannot be simply labeled as additional real needs, because these are also linked to some characteristics of the patients. Consequently, problems of subconsumption cannot be easily solved just by increasing medical supply.