HD 2510 Prelim 2 SG PDF

Aging, health care, & society - Compression of morbidity vs expansion of morbidity - Morbidity (presence of illness in older age) vs mortality (lifespan) - Compression of morbidity: lowers life expectancy but increases quality of life - Expansion of morbidity:...

Aging, health care, & society - Compression of morbidity vs expansion of morbidity - Morbidity (presence of illness in older age) vs mortality (lifespan) - Compression of morbidity: lowers life expectancy but increases quality of life - Expansion of morbidity: increases life expectancy but decreases quality of life - Normal aging - Biological aging & senescence - Series of cumulative, progressive, intrinsic, and ultimately harmful changes that begin to manifest themselves at reproducing maturity and eventually end in death - Primary aging vs secondary aging - Primary aging: changes that are independent of disease - ex) hair turning gray - Secondary aging: disabilities resulting from disease - Geriatrics vs epidemiology - Geriatrics: medical specialty that focuses on aging - Gerontology = study of aging itself, not specific to disease - Epidemiology: study of how often diseases occur in ppl and why - Geriatric epidemiology: Patient care may look different for this older population - What are some of the most common diseases in old age? - Hypertension - 60%, High cholesterol - 51%, Arthritis - 35%, ischemic/coronary heart disease - 29%, Diabetes - 27%, Chronic kidney disease - 25% - Arthritis: inflammation of the joints - Osteoporosis: deterioration of bone tissue - Falling can be a common symptom → may get hip fracture that requires high level of care - Parkinson’s disease: neurological movement disorder - Symptoms include tremors, slow movement, micrograph - Cancer: 2nd leading cause of death - Cardiovascular disease: stroke and heart disease - Dementia: significant problems w memory/thinking - Alzheimer’s disease: most common type of dementia - Health care spending trends - In general, is it increasing vs decreasing? - Healthcare costs are rising - Is Medicare spending increasing or decreasing? - Medicare spending is growing faster than inflation - Health care costs are largest for which age group? - Oldest adults (65+) Medicare - What are the basic eligibility criteria? - Medicare is generally for ppl who are 65+ or who have qualifying disability  - Medicaid is for individuals, families, children with limited resources - What are the four Parts (A, B, C, D)? - Part A: hospital coverage - In hospital, when admitted to hospital, in patient (REUQIRED) - Part B: medical coverage - Not cover all the bills - Outpatient setting, ambulance, testing, physician provided (REQUIRED) - Part C: optional medicare advantage - Private medicare tha toffers additional coverage - Extra advantage like dental, hearing - There is a cap on part C - Part D: optional prescription coverage - Originally did not pay for drugs - Prescription drug coverage - - How does the government pay for Medicare (where does the money come from)? - Funded from payroll taxes on a worker’s income - Approximately what proportion of health care expenses are covered? - Medicare only covers abt half of the out-of-pocket medical expenses of older ppl - Part B reimburses 80% of physician’s reasonable charges - Medigap: private insurance policies cover the remainder of medical bills - What isn’t covered by Medicare? - Eyeglasses - Hearing aids - Dental care - Long-term, non-acute care in nursing homes - Assisted living housekeeping and other fees - Other fees that help adults maintain independence - But does pay for some assistive devices that promote independence - Prosthetics - Walking aids - Cost containment measures - Prospective payment systems - payment method (overall) in which Medicare pays a predetermined, fixed amount for a specific service or diagnosis – part A - Diagnosis-related groups - classification system that determines how much a hospital will be reimbursed for patient care – part A - Resource-Based Relative Value Scale - incentivize medical specialties involving prevention, health promotion vs expensive/high-tech procedures – part B - How did the Inflation Reduction Act (2022) affect Medicare? - $2000 cap on prescription drug costs under Medicare Part D  - Medicare will negotiate drug prices Housing & long-term care - Types - Community-based services (e.g., adult day care, home healthcare) - Adult day care: low cost daytime socialization, entertainment, suprevision - Home health care: in-home help w meals, hygiene, entertainment, transportation - Continuing-care retirement communities (CCRCs) - Age in place, life care communities, transitions with stages - Seniors buy-in for care for the rest of their lives - Includes all level of care starting w independent living and through skilled nursing care in one location - Often have entrance fee → not necessarily accessible to everyone - Medicalized services (e.g., assisted-living facilities, nursing homes) - Assisted-living facilities - Nursing homes: any residential facility giving some degree of nursing care to older adults or ppl w disabilities - Most involvement of care - ⅔ are for profit - Various levels of care - Continuum of care - Aging in place, care transitions from independent living to skilled nursing care - Which types of long-term care/housing are least vs most expensive? - Most expensive is the most hands-on nursing care - Adult day care is cheapest - Hospice vs palliative care - Focuses on quality of life - Treats symptoms rather than disease itself - Hospice care can start when prognosis is