The High Cost of Health Care for the Elderly: Diagnosis, Prognosis, and Some Suggestions for Therapy

Defining the Health Problems of the Elderly

“…Source of paymen (4). The survival curve for Americans is approaching a rectangular shape so that although overall life expectancy may not increase substantially, the number of people surviving to old age will greatly increase (5).…”

“…As a result, not only will the elderly population double to nearly 50 million by the year 2030, but those most susceptible to disease and disability, those over 75, will increase more rapidly. with the number over 85 expected to triple (4). Of the Veteran population.…”

“…Elderly females currently outnumber elderly males by 1.3 to 1; because of the expanding gap in life expectancy, this ratio will increase. Elderly females are much more likely to be widowed and living alone than elderly males (1,4). Social supports, as we discuss in more detail below, are crucial to the elderly's abilities to maintain themselves in the community.…”

“…Social supports, as we discuss in more detail below, are crucial to the elderly's abilities to maintain themselves in the community. Other demo graphic trends, such as fewer marriages, fewer children, and more divorces, will further confound the ability of the elderly to maintain themselves in the community, especially in the face of chronic illness and disability (4). As the older, more impaired population grows and social supports decline, the burden on the less rapidly growing working segment of our population will increase.…”

“…Considerable improvements have been made in the elderly's access to acute and long-tern care since the enactment of Medicare and Medicaid in 1965. The skyrocketing costs of health care for the elderly appear to be due not so much to an increased use (or abuse) of health care services per capita by this segment of the population, but to an increase in the intensity of their medical care (4). Despite this increased access and cost, considerable gaps remain in the availability of appropriate health services to meet major needs of the elderly, such as the care of chronic conditions, mental disorders, dental disease, sensory impairment, preventive care, and supportive services (7,40,(61)(62)(63).…”