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May 2, 1990, Vol 263, No. 17 >
ARTICLE | May 2, 1990

The Aging of America: Title and subTitle BreakImpact on Health Care Costs FREE

Edward L. Schneider, MD; Jack M. Guralnik, MD, PhD
[+] Author Affiliations

Reprint requests to Ethel Percy Andrus Gerontology Center, University of Southern California, University Park, MC 0191, Los Angeles, CA 90089-0191 (Dr Schneider).


JAMA. 1990;263(17):2335-2340. doi:10.1001/jama.1990.03440170057036
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References

The rapid growth of the oldest age groups will have a major impact on future health care costs. We use current US Census Bureau projections for the growth of our oldest age groups to project future costs for Medicare, nursing homes, dementia, and hip fractures. Without major changes in the health of our older population, these health care costs will escalate enormously, in large part as a result of the projected growth of the "oldest old," those aged 85 years and above. Medicare costs for the oldest old may increase sixfold by the year 2040 (in constant 1987 dollars). It is unlikely that these projected increases in health care costs will be restrained solely by cost-containment strategies. Successful containment of these health care costs will be related to our ability to prevent and/or cure those age-dependent diseases and disorders that will produce the greatest needs for long-term care.

(JAMA. 1990;263:2335-2340)

REFERENCES

1 +
Altman SH, Rodwin MA.  Halfway competitive markets and ineffective regulation: the American health care system . J Health Polit Policy Law. 1988;;13:323-339.
2 +
Levit KR, Freeland MS.  Datawatch . Health Aff. 1988;;5:124-136.
3 +
Social Trends . London, England: Central Statistics Office, Dept of Health and Social Security; 1987;:17.
4 +
Rosenswaike IA.  Demographic portrait of the oldest old . Milbank Q. 1985;;63:187-205.
5 +
Guralnik JM, Yanagishita M, Schneider EL.  Projecting the older population of the United States: lessons from the past and prospects for the future . Milbank Q. 1988;;66:283-308.
6 +
Spencer G. Projections of the Population of the United States by Age, Sex and Race: 1988 to 2080 . Washington, DC: US Bureau of the Census; 1989;. Current Population Reports. Series P-25. No. (1018) .
7 +
Hing E. Use of Nursing Homes by the Elderly: Preliminary Data From the 1985 National Nursing Home Survey . Hyattsville, Md: US Public Health Service; 1987;. US Dept of Health and Human Services publication (PHS) 87-1250. Advance Data From Vital and Health Statistics. No. (135) .
8 +
The Supplement on Aging to the 1984 National Health Interview Survey . Hyattsville, Md: National Center for Health Statistics; 1987;. Vital and Health Statistics. Series 1. No. (21) .
9 +
Rice DP, Feldman JJ.  Living longer in the United States: demographic changes and health needs of the elderly . Milbank Q. 1983;;61:362-396.
10 +
Waldo DR, Sonnefeld ST, McKusick DR, Arnett RH III.  Health expenditures by age group, 1977 and 1987 . Health Care Financ Rev. 1989;;10:111-120.
11 +
Hospital Statistics . Chicago, Ill: American Hospital Association; 1987;.
12 +
Lazenby H, Levit KR, Waldo DR. National Health Expenditures, 1985: No. 6 . Washington, DC: Office of Research and Demonstrations, Health Care Financing Administration; 1986;. Publication (HCFA) 03232.
13 +
Schoenberg BS.  Methodologic approaches to the epidemiologic study of dementia . In: Mortimer JA, Schuman L, eds. The Epidemiology of Dementia . New York, NY: Oxford University Press; 1981;:117-131.
14 +
Evans JG.  The epidemiology of dementias in the elderly . In: Brody JA, Maddox GL, eds. Epidemiology and Aging: An International Perspective . New York, NY: Springer-Verlag NY Inc; 1988;:36-53.
15 +
Mortimer JA, Hutton JT.  Epidemiology and etiology of Alzheimer's disease . In: Hutton JT, Kenny AD, eds. Senile Dementia of the Alzheimer Type . New York, NY: Alan R Liss Inc; 1985;:177-196.
16 +
Evans DA, Funkenstein HH, Albert MS, et al.  Prevalence of Alzheimer's disease in a community population of older persons: higher than previously reported . JAMA. 1989;;261:2551-2556.
17 +
Rovner BW, Kafonek S, Filipp L, Lucas MJ, Folstein MF.  Prevalence of mental illness in a community nursing home . Am J Psychiatry. 1986;; 143:1446-1449.
18 +
Hu T, Cartwright WS.  Evaluation of the costs of caring for the senile demented elderly: a pilot study . Gerontologist. 1986;;26:158-163.
19 +
Historical Tables: Budget of the US Government: Fiscal Year, 1989 . Washington, DC: Executive Office of the President, Office of Management and Budget; 1989;.
20 +
Farmer ME, White LR, Brody JA, Bailey KR.  Race and sex differences in hip fracture incidence . Am J Public Health. 1984;;74:1374-1380.
21 +
Miller CW.  Survival and ambulation following hip fracture . J Bone Joint Surg Am. 1978;;60:930-934.
22 +
Kenzora JE, McCarthy RE, Lowell JD, Sledge CB.  Hip fracture mortality: relation to age, treatment, preoperative illness, time of surgery, and complications . Clin Orthop. 1984;;186:45-56.
23 +
Callahan D. Setting Limits . New York, NY: Simon & Schuster Inc Publishers; 1987;.
24 +
Finch CE, Schneider EL, eds. Handbook of the Biology of Aging . New York, NY: Van Nostrand Reinhold Co; 1985;.
25 +
Jecker NS, Pearlman RA.  Ethical constraints on rationing medical care by age . J Am Geriatr Soc. 1989;;37:1067-1075.
26 +
Special Report on Alzheimer's Disease . Bethesda, Md: National Institute on Aging; 1988;.
27 +
Havlik RJ, Liu BM, Kovar MG, et al. Health Statistics on Older Persons, United States, 1986 . Washington, DC: US Public Health Service; 1987;:66. US Dept of Health and Human Services publication (PHS) 87-1409. Vital and Health Statistics. Series 3. No. (25) .

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Altman SH, Rodwin MA.  Halfway competitive markets and ineffective regulation: the American health care system . J Health Polit Policy Law. 1988;;13:323-339.
2 +
Levit KR, Freeland MS.  Datawatch . Health Aff. 1988;;5:124-136.
3 +
Social Trends . London, England: Central Statistics Office, Dept of Health and Social Security; 1987;:17.
4 +
Rosenswaike IA.  Demographic portrait of the oldest old . Milbank Q. 1985;;63:187-205.
5 +
Guralnik JM, Yanagishita M, Schneider EL.  Projecting the older population of the United States: lessons from the past and prospects for the future . Milbank Q. 1988;;66:283-308.
6 +
Spencer G. Projections of the Population of the United States by Age, Sex and Race: 1988 to 2080 . Washington, DC: US Bureau of the Census; 1989;. Current Population Reports. Series P-25. No. (1018) .
7 +
Hing E. Use of Nursing Homes by the Elderly: Preliminary Data From the 1985 National Nursing Home Survey . Hyattsville, Md: US Public Health Service; 1987;. US Dept of Health and Human Services publication (PHS) 87-1250. Advance Data From Vital and Health Statistics. No. (135) .
8 +
The Supplement on Aging to the 1984 National Health Interview Survey . Hyattsville, Md: National Center for Health Statistics; 1987;. Vital and Health Statistics. Series 1. No. (21) .
9 +
Rice DP, Feldman JJ.  Living longer in the United States: demographic changes and health needs of the elderly . Milbank Q. 1983;;61:362-396.
10 +
Waldo DR, Sonnefeld ST, McKusick DR, Arnett RH III.  Health expenditures by age group, 1977 and 1987 . Health Care Financ Rev. 1989;;10:111-120.
11 +
Hospital Statistics . Chicago, Ill: American Hospital Association; 1987;.
12 +
Lazenby H, Levit KR, Waldo DR. National Health Expenditures, 1985: No. 6 . Washington, DC: Office of Research and Demonstrations, Health Care Financing Administration; 1986;. Publication (HCFA) 03232.
13 +
Schoenberg BS.  Methodologic approaches to the epidemiologic study of dementia . In: Mortimer JA, Schuman L, eds. The Epidemiology of Dementia . New York, NY: Oxford University Press; 1981;:117-131.
14 +
Evans JG.  The epidemiology of dementias in the elderly . In: Brody JA, Maddox GL, eds. Epidemiology and Aging: An International Perspective . New York, NY: Springer-Verlag NY Inc; 1988;:36-53.
15 +
Mortimer JA, Hutton JT.  Epidemiology and etiology of Alzheimer's disease . In: Hutton JT, Kenny AD, eds. Senile Dementia of the Alzheimer Type . New York, NY: Alan R Liss Inc; 1985;:177-196.
16 +
Evans DA, Funkenstein HH, Albert MS, et al.  Prevalence of Alzheimer's disease in a community population of older persons: higher than previously reported . JAMA. 1989;;261:2551-2556.
17 +
Rovner BW, Kafonek S, Filipp L, Lucas MJ, Folstein MF.  Prevalence of mental illness in a community nursing home . Am J Psychiatry. 1986;; 143:1446-1449.
18 +
Hu T, Cartwright WS.  Evaluation of the costs of caring for the senile demented elderly: a pilot study . Gerontologist. 1986;;26:158-163.
19 +
Historical Tables: Budget of the US Government: Fiscal Year, 1989 . Washington, DC: Executive Office of the President, Office of Management and Budget; 1989;.
20 +
Farmer ME, White LR, Brody JA, Bailey KR.  Race and sex differences in hip fracture incidence . Am J Public Health. 1984;;74:1374-1380.
21 +
Miller CW.  Survival and ambulation following hip fracture . J Bone Joint Surg Am. 1978;;60:930-934.
22 +
Kenzora JE, McCarthy RE, Lowell JD, Sledge CB.  Hip fracture mortality: relation to age, treatment, preoperative illness, time of surgery, and complications . Clin Orthop. 1984;;186:45-56.
23 +
Callahan D. Setting Limits . New York, NY: Simon & Schuster Inc Publishers; 1987;.
24 +
Finch CE, Schneider EL, eds. Handbook of the Biology of Aging . New York, NY: Van Nostrand Reinhold Co; 1985;.
25 +
Jecker NS, Pearlman RA.  Ethical constraints on rationing medical care by age . J Am Geriatr Soc. 1989;;37:1067-1075.
26 +
Special Report on Alzheimer's Disease . Bethesda, Md: National Institute on Aging; 1988;.
27 +
Havlik RJ, Liu BM, Kovar MG, et al. Health Statistics on Older Persons, United States, 1986 . Washington, DC: US Public Health Service; 1987;:66. US Dept of Health and Human Services publication (PHS) 87-1409. Vital and Health Statistics. Series 3. No. (25) .

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