Long-Term Care and Aging HAS 4320. Aging Society Americans are living longer Chronic disease is...
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Transcript of Long-Term Care and Aging HAS 4320. Aging Society Americans are living longer Chronic disease is...
Aging Society
• Americans are living longer
• Chronic disease is taking a bigger toll
• Growing number of older adults
• Disability
Long-Term Care
• Acute hospital
• Rehab hospital
• Nursing home
• CCRC
• Skilled home care
• Personal home care
• Family/community
Long-Term Care Insurance
• Location
• Type
• Options of benefit
• Waiting periods
• Mental illness/Alzheimer’s
LTC insurance: not popular
• Incidence is less random
• Must be purchased earlier
• Medicaid is there
• Helps heirs more than patients
Aging Population: Labor Supply
• Workers to retirees declines
• Output per capita and living standards will be lower
Health Care Expenditures (1996)
• Elderly in institutions = $38,906
• Elderly in the community = $6,360
• 1% of Medicare beneficiaries incurred 13% of health care expenditures.
• Top 5% of enrollees with highest expenditures = 37% of total.
Components (1996)
• 30% = hospital care
• 10% = skilled nursing care
• 46% = nursing home for 85 and older
• 7% = nursing home for 65 to 69
• Lower income = higher cost
• No insurance = lower total drug expenditures, but higher costs on drugs
Out-of-Pocket Expenses (1998)
• 9 to 16% of total
• Dollar expenditure increases with income
• Relative burden is much higher on lower income
• Share spent by all income groups has increased
Access to Health Care
• Difficulties are down
• Delays due to costs are down
• Delays highest among non-Hispanic Blacks (10%) then Hispanic persons (7%) and non-Hispanic Whites (5%).
Use (1998)
• Physician visits have increased
• Home health visits have increased
• Hospitalizations has slightly increased
• Skilled nursing has increased
• Visits increased markedly with age
Nursing Home Use (1997)
• About half of residents are 85 or older
• Use has declined (assisted living centers)
• Women more than men
• Functional limitations have increased
• Rates of functional limitations higher among 65-74 year olds.