Ger 1 Lecture

Question 1

How many people were 65+ in 2005?

Answer 1

36.6 million

Question 2

What % of the population was 65+ in 2005?

Answer 2

12.4% of US population (1 in 8)

Question 3

Since 1990, the % of Americans increased from 4.1% to?

Answer 3

12.4% in 2004 –> It tripled

Question 4

What has the number of Americans 65+ done since 1990?

Answer 4

Increased almost 12 times

(3.1 million to 36.3 million

Question 5

In 2005, the 65-74 age group was how many times larger than in 1990?

Answer 5

8.5 times (18.6 million)

Question 6

In 2005, the 75-84 age group was how many times larger than in 1990?

Answer 6

17 times larger (13.1 million)

Question 7

In 2005, the 85+ age group was how many times larger than in 1990?

Answer 7

42 times larger (5.1 million)

Question 8

In 2000, how many Americans were 65+?

Answer 8

35 million

Question 9

In 2010, how many million Americans were 65+ and what was the % increase from 2000?

Answer 9

40 million, 15% increase

Question 10

In 2030, what is the predicted number of Americans 65+ and what will be the % increase from 2010?

Answer 10

55 million, 36% increase

Question 11

In 2000, how many Americans were 85+?

Answer 11

4.2 million

Question 12

In 2010, how may million Americans were 85+ and what was the % increase from 2000?

Answer 12

6.1 million, 40% increase

Question 13

In 2030, what is the predicted number of Americans 85+ and what was the % increase from 2010?

Answer 13

7.3 million, 44% increase

Question 14

In men over 65, what % lives with a spouse?, alone?, Other?

Answer 14

72% with spouse
19% alone
9% other

Question 15

In women over 65, what % lives with a spouse?, alone?, other?

Answer 15

42% with spouse
38% alone
20% other

Question 16

What are the 4 highest states with the greatest number 65+?

Answer 16

1. California
2. Florida
3. Pennsylvania
4. New York

Question 17

What are the 3 highest states that have the greatest % of 65+ (in 2005)?

Answer 17

1. Florida
2. West Virginia
3. Pennsylvania

Question 18

Elderly represent what % of population?

Answer 18

13%

Question 19

Elderly represent what % of hospital stays?

Answer 19

36%

Question 20

Elderly represent what % of all days of hospital care?

Answer 20

49%

Question 21

Elderly represent what % of all physician hours?

Answer 21

50%

Question 22

How many chronic conditions does the average 75 year old have?

Answer 22

3

Question 23

The average 75 year old uses what % of all prescription drugs?

Answer 23

4.5%

Question 24

How many average 75 year olds have at least 1 disabling condition?

Answer 24

1 in 4

Question 25

Chronic disease results in what % of hospital stays and that % of Medicare costs?

Answer 25

70% hospital stays | 60% Medicare costs

Question 26

What % of all hospital admission are caused by inappropriate drug prescribing?

Answer 26

17%

Question 27

By age 80, how many elderly have at least 1 disability (many have multiple disabilities and chronic conditions)?

Answer 27

3 out of 4

Question 28

Medication problems cause what % of all hospital admissions?

Answer 28

17%

Question 29

How many elderly receive inappropriate prescriptions?

Answer 29

1 in 5

Question 30

What is the geriatric health care work force in?

Answer 30

CRISIS

Question 31

What are the 10 reasons for the shortage of geriatric practicioners?

Answer 31

1. Age denial 2. Marginalization of older patients 3. Lack of public awareness of geriatrics gap 4. Scarcity of academic leaders 5. Lack of academic infrastructure in geriatrics 6. Geriatric medicine not valued 7. Inadequate reimbursement 8. Lack of coordination within medicine 9. Clinical trials do not include elderly 10. Minimal research on the aging process

Question 32

What are the 5 features of the paradigm shift seen in the health system of the 21st century?

Answer 32

1. Patient-centered 2. Continuous healing relationship between patients and the interdisciplinary health care team 3. Cooperation among clinicians 4. Evidence-based decision-making 5. Transparency

Question 33

What are the 3 pathways to the future?

Answer 33

1. Interdisciplinary team 2. Management information systems 3. Community-based training

Question 34

What can we anticipate?

Answer 34

1. Increasing complexity of diagnosis due to technologic, scientific, genetic advances 2. Changes in organization, financing of care 3. Demonstration of safe, efficient, effective practice styles 4. Changing patient needs and expectations 5. Management of chronic disease 6. Focus on prevention, behavior change, maximizing function 7. Enhanced communication through technology 8. Development of new educational models 9. Change from a model of illness care to wellness/health promotion 10. Increased role for self-management of disease by patients and their families 11. New incentives for quality

Question 35

What are the 5 steps done in redesigning the system of care?

Answer 35

1. Increase reliability of care delivery process: Information technology 2. Translate research into practice: Evidence-based approach 3. Create and maintain interdisciplinary teams 4. Coordinate with community-based agencies and the public health system 5. Performance and outcome measures

Question 36

What is the care system?

Answer 36

A "living laboratory" in which education of health care providers takes place - It is symbiotic and synergistic - You cannot divorce the system of care from education

Question 37

What are 5 common characteristics of new models of care?

Answer 37

1. Designed to maximize health, function, quality, and satisfaction 2. Interdisciplinary 3. Patient-centered focus: Patient part of the team, Self-management/empowerment 4. Based on evidence (e.g., nutrition, exercise, counseling, community-based services) 5. Information technology enhances care, intervention, monitoring and communication

Question 38

What is medicare?

Answer 38

A legistlation passed by the US government in 1965 to improve access to acute health care for people who are old, disabled or poor *The medicare and medicaid programs expanded over the years to a complex array for commercial insurance plans

Question 39

Who runs medicare?

Answer 39

The Centers for Medicare and Medicaid services (CMS) | [Medicare is a federal insurance program]

Question 40

What does medicare Part A and B do?

Answer 40

Pays for health professionals and organization to provide acute health care for Americans who are 65 and older, disabled, or suffering from end-stage renal disease

Question 41

How does medicare part A work?

Answer 41

- Part A uses regional insurance companies (intermediaries) to pay hospitals, nursing homes, home-care agencies, and hospice programs for the Medicare-covered services they provide. - Older Americans (and their spouses) who have had Medicare taxes deducted from their paychecks for at least 10 years are entitled to the coverage - Others may be able to purchase for $189-343 per month depending on how long they have medicare taxes deducted

Question 42

How does medicare part B work?

Answer 42

-Part B, uses other regional insurance companies (carriers) to pay physicians, nurse practitioners, social workers, psychologist, rehabilitation therapist, home-care agencies, ambulances, outpatient facilities, laboratory and imaging facilities, and suppliers of durable medical equipment for the Medicare-covered goods and services they provide

Question 43

When do people become eligible for Part B coverage?

Answer 43

-At age 65, if they are entitled to Part A coverage or if they are citizens or permanent residents of the US

Question 44

How do people enroll in Part B?

Answer 44

They enroll when they are eligble and pay premiums ($78 per month), usually by agreeing to have them deducted from their monthly social security checks

Question 45

What do physicians have to do with regards to medicare?

Answer 45

They have to choose whether to participate in the FFS (Fee-For service) Medicare program

Question 46

What % do physicians get paid of a submitted claim (pre-establish "allowed" amount)

Answer 46

80%

Question 47

What can physicians do for payment for what's not covered by Medicare?

Answer 47

They can bill the patients or their secondary insurer for no more than a 20% co-insurance payment