Beyond Healthcare Spending: Inequalities in the Use of Preventive Health Services among Europeans aged over 50

This study examines the factors influencing the use of preventive health services (PHS) among individuals over 50 living in their own homes, in light of rising healthcare expenditures. Drawing on Andersen’s Behavioural Model (ABM), the analysis incorporates individual-level variables (such as personality traits, Internet use, trust, and praying) and contextual country-level data. The study uses data from the SHARE survey and international sources (World Bank, Eurostat, OECD), covering 29,201 individuals across 15 European countries.Initial analyses employed multiple logistic regression models by country, followed by multilevel logistic regression models with individual factors at level one and country-level factors at level two. Results show that women are more likely than men to use preventive services such as eye exams and dental visits. Higher income, better satisfaction with health coverage, supplementary insurance, higher education, and Internet use increase the likelihood of using preventive services (except for general practitioner visits). Being married is also positively associated with service use, while living in smaller towns is linked to greater preventive use of specialists, flu vaccinations, and mammograms.Among personality traits, conscientiousness is the most strongly associated with increased use of mammograms, eye exams, and dental visits. The models explain between 10.5% and 35.8% of the variation in service use.Although the World Health Organization prioritizes access to PHS, the findings suggest limited progress. Strengthening prevention strategies not only improves quality of life but also helps reduce healthcare costs over time.