Aetna Inc. will become the latest insurer to tell investors whether health care use is picking up when it reports fourth-quarter results on Wednesday.

What to watch for: Insurers have been helped the past several quarters by health care use that has climbed at rates that were lower than expected when they set premiums. Many say the trend is driven by a pullback in consumer spending, and analysts expect it to continue into 2012, but there are some signs this is slowly changing.

Aetna competitor WellPoint Inc. said last week use rose in the fourth quarter but remained lower than normal, and trends were affected more by the cost of care than the number of people receiving it. In other words, the insurer saw bigger hospital bills from more acute cases rather than more people heading to the hospital.

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