Ger 1 Lecture Flashcards
How many people were 65+ in 2005?
36.6 million
What % of the population was 65+ in 2005?
12.4% of US population (1 in 8)
Since 1990, the % of Americans increased from 4.1% to?
12.4% in 2004 –> It tripled
What has the number of Americans 65+ done since 1990?
Increased almost 12 times
(3.1 million to 36.3 million
In 2005, the 65-74 age group was how many times larger than in 1990?
8.5 times (18.6 million)
In 2005, the 75-84 age group was how many times larger than in 1990?
17 times larger (13.1 million)
In 2005, the 85+ age group was how many times larger than in 1990?
42 times larger (5.1 million)
In 2000, how many Americans were 65+?
35 million
In 2010, how many million Americans were 65+ and what was the % increase from 2000?
40 million, 15% increase
In 2030, what is the predicted number of Americans 65+ and what will be the % increase from 2010?
55 million, 36% increase
In 2000, how many Americans were 85+?
4.2 million
In 2010, how may million Americans were 85+ and what was the % increase from 2000?
6.1 million, 40% increase
In 2030, what is the predicted number of Americans 85+ and what was the % increase from 2010?
7.3 million, 44% increase
In men over 65, what % lives with a spouse?, alone?, Other?
72% with spouse
19% alone
9% other
In women over 65, what % lives with a spouse?, alone?, other?
42% with spouse
38% alone
20% other
What are the 4 highest states with the greatest number 65+?
- California
- Florida
- Pennsylvania
- New York
What are the 3 highest states that have the greatest % of 65+ (in 2005)?
- Florida
- West Virginia
- Pennsylvania
Elderly represent what % of population?
13%
Elderly represent what % of hospital stays?
36%
Elderly represent what % of all days of hospital care?
49%
Elderly represent what % of all physician hours?
50%
How many chronic conditions does the average 75 year old have?
3
The average 75 year old uses what % of all prescription drugs?
4.5%
How many average 75 year olds have at least 1 disabling condition?
1 in 4
Chronic disease results in what % of hospital stays and that % of Medicare costs?
70% hospital stays
60% Medicare costs
What % of all hospital admission are caused by inappropriate drug prescribing?
17%
By age 80, how many elderly have at least 1 disability (many have multiple disabilities and chronic conditions)?
3 out of 4
Medication problems cause what % of all hospital admissions?
17%
How many elderly receive inappropriate prescriptions?
1 in 5
What is the geriatric health care work force in?
CRISIS
What are the 10 reasons for the shortage of geriatric practicioners?
- Age denial
- Marginalization of older patients
- Lack of public awareness of geriatrics gap
- Scarcity of academic leaders
- Lack of academic infrastructure in geriatrics
- Geriatric medicine not valued
- Inadequate reimbursement
- Lack of coordination within medicine
- Clinical trials do not include elderly
- Minimal research on the aging process
What are the 5 features of the paradigm shift seen in the health system of the 21st century?
- Patient-centered
- Continuous healing relationship between patients and the interdisciplinary health care team
- Cooperation among clinicians
- Evidence-based decision-making
- Transparency
What are the 3 pathways to the future?
- Interdisciplinary team
- Management information systems
- Community-based training
What can we anticipate?
- Increasing complexity of diagnosis due to technologic, scientific, genetic advances
- Changes in organization, financing of care
- Demonstration of safe, efficient, effective practice styles
- Changing patient needs and expectations
- Management of chronic disease
- Focus on prevention, behavior change, maximizing function
- Enhanced communication through technology
- Development of new educational models
- Change from a model of illness care to wellness/health promotion
- Increased role for self-management of disease by patients and their families
- New incentives for quality
What are the 5 steps done in redesigning the system of care?
- Increase reliability of care delivery process: Information technology
- Translate research into practice: Evidence-based approach
- Create and maintain interdisciplinary teams
- Coordinate with community-based agencies and the public health system
- Performance and outcome measures
What is the care system?
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
What are 5 common characteristics of new models of care?
- Designed to maximize health, function, quality, and satisfaction
- Interdisciplinary
- Patient-centered focus: Patient part of the team, Self-management/empowerment
- Based on evidence (e.g., nutrition, exercise, counseling, community-based services)
- Information technology enhances care, intervention, monitoring and communication
What is medicare?
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
Who runs medicare?
The Centers for Medicare and Medicaid services (CMS)
[Medicare is a federal insurance program]
What does medicare Part A and B do?
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
How does medicare part A work?
- 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
How does medicare part B work?
-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
When do people become eligible for Part B coverage?
-At age 65, if they are entitled to Part A coverage or if they are citizens or permanent residents of the US
How do people enroll in Part B?
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
What do physicians have to do with regards to medicare?
They have to choose whether to participate in the FFS (Fee-For service) Medicare program
What % do physicians get paid of a submitted claim (pre-establish “allowed” amount)
80%
What can physicians do for payment for what’s not covered by Medicare?
They can bill the patients or their secondary insurer for no more than a 20% co-insurance payment
