wherever possible future evolution of the volume of services and their relative costs were estimated separately it is worth noting that population aging is expected to have a much greater cost pressure on social care expenditures than on health care expenditures the increase in the volume of activities is then adjusted for changes in activity rates which accounts for quality improvements eg reducing waiting times and guaranteeing specific treatments the availability of new medical technologies and productivity improvements in particular the use of information and communication technology to increase effectiveness future unit costs were obtained by multiplying the reference year costs by a cost adjustment factor which accounts for variation in health specific prices