Healthcare Delivery to the Elderly

Elderly individuals face a number of conditions that require medical services or attention. These conditions include functional limitations, the need for medications to stave off medical conditions associated with aging, and surgeries or procedures to maintain independence, such as cataract surgery or hip replacements. People are living longer than in the past.

The AHRQ

• The Task Force on Aging is comprised of staff from the Agency for Healthcare Research and Quality (AHRQ). In 1999, the AHRQ designated the elderly as a "priority population for health services research." In 2000, the agency requested proposals for research studies to address the issues of improving healthcare delivery to the elderly. In addition, the AHRQ created the Excellence Centers to Eliminate Ethnic/Racial Disparities (EXCEED) and the Evidence-based Practice Center (EPC) program to deal with issues related to quality healthcare for older persons.

Elder Population

• There is an ever-growing number of Americans who fit the definition of "elderly." The AHRQ notes that by the year 2011, 77 million baby boomers will reach the age of 65. By the year 2025, 69.3 million seniors will be on Medicare. About one forth of all seniors (65 or older) will be from a racial or ethnic minority by the year 2030. As the elderly population grows, social trends will prevent many families from taking care of their elder family members.

Care Facilities

• There are many types of healthcare facilities that provide healthcare services to older Americans. These include nursing homes, assisted living centers, life care facilities, residential care facilities, life care communities, congregate housing and others. The exact type of facility available varies by location. Estimates on the number of assisted care facilities in the United States range from 10,000 to 40,000. The type of healthcare services provided depends on state regulations and facility policies. The AHRQ predicts a growing number of seniors will utilize the services provided by community-based care facilities due to changes in financing options for long-term care as well as changes in the healthcare system.

Health Services

• Improvements in technology make it possible to provide many services and treatments outside of hospitals. Insurance company policies that reduce payments for hospital stays are partially responsible for the trend toward outpatient, treatment facilities for older Americans. Medicare covers rehabilitative, restorative and end-of-life care in a facility that provides skilled nurses. It also covers in-home care, end-stage renal disease services and hospice services.

Emergency Rooms

• People over the age of 65 are more likely to seek medical treatment in hospital emergency rooms for chronic conditions or conditions that do not require surgery. Between 1992 and 2000 the number of persons aged 65 or older seeking treatment in an emergency room increased by 21 percent. The statistics indicate black elderly persons are more likely to seek treatment in emergency rooms (51 percent increase) compared to their white peers (19 percent increase). Differences are attributed to fewer older blacks having private insurance, limited resources to get needed prescriptions and difficulty in finding a personal physician who accepts new patients.