ABSTRACT
It is widely recognized that persons 65 years of age and older are disproportionately high users of health services (Lubitz and Prihoda 1983; Soldo and Manton 1985; Waldo and Lazenby 1984). For example, American elderly (11.3 percent of that population group) accounted for 29.6 percent of total health care expenditures in 1980 (Kovar 1986). Canada elderly (9.7 percent of that population) accounted for approximately 20 to 25 percent of total health care expenditures in 1981 (Fletcher 1986). Such generalized statements, however, are misleading. The elderly are not homogeneous with respect to their physician and hospital use. Indeed, a substantial portion of the utilization attributed to them is due to the extensive demand generated by a relatively small subgroup. Indeed, 12 percent of the community-dwelling American elderly account for 70.5 percent of that group’s health care expenditures (Kovar 1986).
