The changing elderly population and future health care needs.
The impending growth of the elderly population requires both fiscal and substantive changes in Medicare and Medicaid that are responsive to cost issues and to changing patterns of need. More emphasis is required on chronic disease management, on meaningful integration between acute and long-term care services, and on improved coordination between Medicare and Medicaid initiatives. This paper reviews various trends, including the growth in managed-care approaches, experience with social health maintenance organizations and Program of All-Inclusive Care for the Elderly demonstrations, and the need for a coherent long-term care policy. Such policies, however, transcend health care and require a broad range of community initiatives.
Mechanic
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Institute for Health, Health Care Policy, and Aging Research, Rutgers, State University, New Brunswick, NJ 08901-1293, USA. mechanic@rci.rutgers.edu
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease; D003365:Costs and Cost Analysis; D005544:Forecasting; D006279:Health Maintenance Organizations / Q000191:economics / Q000639:trends; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000191:economics / Q000639:trends*; D006299:Health Services for the Aged / Q000191:economics / Q000639:trends*; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000639:trends; D008329:Managed Care Programs / Q000191:economics / Q000639:trends; D008484:Medicaid / Q000191:economics / Q000639:trends; D006278:Medicare / Q000191:economics / Q000639:trends; D011157:Population Dynamics; D014481:United States