The Aging of the Population and Health Services

Abstract

The demographic revolution—engendered in large part by modern medicine—which has led to the extraordinary and continuing increase in the number and proportion of elderly persons in the population has profound implications for health services. The elderly are disproportionately heavy utilizers of health care, primarily because of the prevalence of chronic disease. In the United States most health care for the elderly is financed through public funds, and costs have been increasing at an alarming rate. There is wide consensus that, for all the excellence of performance of the medical care system in treating acute episodes, care of chronic disease is frequently unsatisfactory in both quality and cost. Given the demographic imperatives, reform of mechanisms for chronic care is thus essential.

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References

1. Donald O. Cowgill , “The Aging of Populations and Societies,” The Annals of the American Academy of Political and Social Science, 415:1-18 (Sept. 1974).

2. Walsh McDermott and David Rogers , “Social Ramifications of Control of Microbial Disease,” Johns Hopkins Medical Journal (Dec. 1982, in press).

3. C. Allen and H. Brotman , eds., Chartbook on Aging in America (Washington, DC: 1981 White House Conference on Aging, 1981), pp. 78-79.

4. Ibid., p. 80.

5. Leighton Cluff , “Chronic Disease, Function, and the Quality of Care,” Journal of Chronic Diseases, 34(7): 299-304 (1981).

6. Jacob Feldman , “Work Ability of the Aged under Conditions of Improving Mortality” (Statement before the National Commission on Social Security Reform, 21 June 1982).

7. T. Smuding , Alternative Methods for Valuing Selected In-Kind Transfer Benefits and Measuring Their Effect on Poverty, technical paper 50 (Washington, DC: Bureau of the Census, 1982).

8. Allen and Brotman , eds., Chartbook on Aging in America, p. 57.

9. Ibid., p. 63.

10.

10. Sylvester Schieber and Patricia George , Retirement Opportunities in an Aging America: Coverage and Benefit Entitlement (Washington, DC: Employment Benefit Research Institute, 1981), p. 25.

11.

11. Bruce Jacobs , An Overview of the National Potential of Home Equity Conversion into Income for the Elderly (Madison, WI: Home Equity Conversion Project, 1982).

12.

12. U.S., Congress, House , Select Committee on Aging, Every Ninth American, comm. pub. no. 97-332 (Washington, DC: Government Printing Office, 1982).

13.

Ethel Shanas , “The Family as a Social Support System in Old Age,” The Gerontologist, 19(2):169-174 (Apr. 1979).

14.

14. Department of Health and Human Services, Public Health Service , Health U.S. 1981 (Hyattsville, MD: DHHS, 1981), Tables 39, 42, 44; Robert Wood Johnson Foundation , Special Report: Medical Practice in the United States (Princeton, NJ: Robert Wood Johnson Foundation, 1981), Figure 2.2.

15.

15. Health U.S. 1981, Table 41; see also earlier editions.

16.

16. Robert Wood Johnson Foundation , Medical Practice in the United States, Figure 2.2.

17.

17. Cluff , “Chronic Disease, Function, and the Quality of Care.”

18.

18. Laurence G. Branch and Alan M. Jette , “A Prospective Study of Long-Term Care Institutionalization among the Aged,” American Journal of Public Health, 72:1373-1379 (Dec. 1982).

19.

19. Charles R. Fisher , “Differences by Age Groups in Health Care Spending,” Health Care Financing Review, 1:79 (Spring 1980).

20.

20. Donald N. Muse and Darwin Sawyer , The Medicare and Medicaid Data Book, 1981 (Baltimore: Department of Health and Human Services, Health Care Financing Administration, 1982), p. 105.

21.

21. Karen Davis and Cathy Schoen , Health and the War on Poverty: A Ten-Year Appraisal (Washington, DC: Brookings Institution, 1978), p. 105.

22.

22. Muse and Sawyer , Medicare and Medicaid Data Book, pp. 31, 107-109.

23.

23. Ibid., p. 20.

24.

24. Davis and Schoen , Health and the War on Poverty, pp. 97-98.