title: Population change: friend or foe of the chronic care system?
abstract: The care needs of the "frail" elderly represent a large part of the chronic care system and are met through a variety of means, including the services of family members. Consequently, projected growth in the elderly population, combined with increasing demands on their shrinking families, seems to imply both demand- and supply-side pressures on the chronic care system. Yet recent downward trends in old-age disability suggest to some that care needs might not grow. I review evidence relevant to these demand- and supply-side factors, with particular attention to the distinction between trends and compositional change, the factors' respective contributions to declining disability, and their prospects for continuation in the future. I conclude that population change is more likely to be foe than friend of the chronic care system for several decades.
authors.affiliation: Aging Studies Program, Maxwell School of Citizenship and Public Affairs, Syracuse University, New York, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Wolf
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D003695:Delivery of Health Care / Q000458:organization & administration*; D003710:Demography; D005006:Ethnicity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D014481:United States / Q000453:epidemiology