scholarly journals Forecasting the Health Transition and Medical Expenditure of the Future Elderly in China: A Longitudinal Study Based on Markov Chain and Two Part Model

2022 ◽  
Vol 9 ◽  
Author(s):  
Yuan Gao ◽  
Jingbo Li ◽  
Xin Yuan
Keyword(s):  
Transition Probability ◽  
Rapid Development ◽  
The Elderly ◽  
Medical Expenditure ◽  
Gender Mainstreaming ◽  
Health State ◽  
Health Transition ◽  
Term Care ◽  
The Future ◽  
Part Model

Set in the rapid development of population aging, this study focuses on the relationship between health and medical expenditure of the elderly population. Taking the health and medical expenditure of the elderly as the research object, this study analyzes the characteristics and the intrinsic relationship between them. Based on the future elderly model, this study calculates the transition probability of the elderly's self-assessment health state using the Health Transition Model and estimates the medical expenditure of the elderly by the Two-Part Model. Based on the above, this study predicts the trend of the population size and medical expenditure of the elderly in the next 15 years (2020–2035). Based on the results, the policy suggestions are put forward. To begin with, strengthening health management and health services for the elderly in the construction of healthy China. Next, building a comprehensive system of health care for the elderly in government, society, family, and individual. Then, establishing a long-term care service system as soon as possible. In addition, it is better to establish lifelong health consciousness and cultivate healthy accomplishment behavior. Finally, it is necessary to promote gender mainstreaming in the health field.

scholarly journals The Health Status Transition and Medical Expenditure Evaluation of Elderly Population in China

2021 ◽  
Vol 18 (13) ◽  
pp. 6907
Author(s):  
Lianjie Wang ◽  
Yao Tang ◽  
Farnaz Roshanmehr ◽  
Xiao Bai ◽  
Farzad Taghizadeh-Hesary ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
Elderly Population ◽  
The Elderly ◽  
Severe Disability ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Population Increase ◽  
Health Transition ◽  
Status Transition

(1) Background: Because of the rapid expansion of the aging population in China, their health status transition and future medical expenditure have received increasing attention. This paper analyzes the health transition of the elderly and how their health transition impacts medical expenditures. At the same time, feasible policy suggestions are provided to respond to the rising medical expenditure and the demand for social care. (2) Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 and analyzed using the Markov model and the Two-Part model (TPM) to forecast the size of the elderly population and their medical expenditures for the period 2020–2060. (3) Results: The study indicates that: (1) for the elderly with a mild disability, the probability of their health improvement is high; in contrast, for the elderly with a moderate or severe disability, their health deterioration is almost certain; (2) the frequency of the diagnosis and treatments of the elderly is closely related to their health status and medical expenditure; alternatively, as the health status deteriorates, the intensity of the elderly individuals’ acceptance of their diagnosis and treatment increases, and so does the medical expense; (3) the population of the elderly with mild and moderate disability demonstrates an inverted “U”-shape, which reaches a peak around 2048, whereas the elderly with severe disability show linear growth, being the target group for health care; (4) with the population increase of the elderly who have severe disability, the medical expenditure increases significantly and poses a huge threat to medical service supply. Conclusions: It is necessary to provide classified and targeted health care according to the health status of the elderly. In addition, improving the level of medical insurance, establishing a mechanism for sharing medical expenditure, and adjusting the basic demographic structure are all important policy choices.

scholarly journals Application of Artificial Sunlight for the Elderly as a Possible Environmental Nursing Practice

2018 ◽  
Vol 2 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Shigeru Goto ◽  
Toshiaki Nakano ◽  
Chao-Long Chen ◽  
King-Wah Chiu ◽  
Li-Wen Hsu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nursing Practice ◽  
The Elderly ◽  
Medical Expenditure ◽  
Clinical Settings ◽  
Term Care ◽  
Aged People ◽  
Beneficial Effects ◽  
Healthy Longevity ◽  
Aged Person

Aging and aged societies have arrived in many countries where significant development of medicine and the economy has been achieved. Japan is a highly aged society with a shortage of carers both at home and in long-term care settings. In fact, more persons of advanced age who do not need intensive care in hospitals strongly desire health care to be delivered in their own home with their family. Environmental nursing practice, which means that nurses improve the environment of patients or the elderly properly in accordance with healthcare considerations, is currently playing a more important role, not only to prevent the elderly from contracting various diseases, but also to provide a facility for supporting an aged person to live a fulfilling life, preferably one that includes independence. This approach will lead to a reduction in medical expenditure by increasing the number of aged people with healthy longevity without the need for hospitalization or intensive care. This short communication focuses on healthy lighting for the elderly based on our research and experience regarding the beneficial effects of artificial sunlight on nonalcoholic steatohepatitis (NASH), asthma and food allergy, and ulcerative colitis in experimental animal models and clinical settings. Then, we review other studies and discuss how artificial sunlight would be useful for the elderly as one of the environmental nursing practices. Keywords: Artificial Sunlight, Phototherapy, Elderly People, Environmental Nursing, Vitamin D

Devolution and Aging Policy: Racing to the Bottom in Long-Term Care

1997 ◽  
Vol 27 (3) ◽  
pp. 427-442 ◽  
Author(s):  
Carroll L. Estes ◽  
Karen W. Linkins
Keyword(s):  
Long Term Care ◽  
Nonprofit Sector ◽  
State Level ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
New Federalism ◽  
Trade Offs ◽  
The Future

For two decades, New Federalism, devolution, and other challenges to the federal role in domestic health and human services policy have fundamentally shaped the structure and delivery of long-term care in the United States. Devolution evokes crucial questions concerning the future of universal entitlement programs such as Social Security and Medicare and, with them, the future of aging and long-term care policy. This article examines the implications of the “devolution revolution” for long-term care in the context of the sociodemographics of aging and the managed care movement. Central issues are the extent to which state-level discretionary policy options (1) alter priorities, services, and benefits for the elderly and disabled; (2) foster a race to the bottom in long-term care; (3) promote generational, gender, racial and ethnic, and social class trade-offs; and (4) fundamentally alter the role and capacity of nonprofit sector services that comprise a significant part of the long-term care continuum.

scholarly journals Valuation of long-term care options embedded in life annuities

2021 ◽  
pp. 1-27
Author(s):  
An Chen ◽  
Michel Fuino ◽  
Thorsten Sehner ◽  
Joël Wagner
Keyword(s):  
Long Term Care ◽  
Numerical Study ◽  
Transition Probability ◽  
The Elderly ◽  
Term Care ◽  
Life Annuity ◽  
Societal Challenges ◽  
Life Annuities ◽  
Industrialised Countries

Abstract In most industrialised countries, one of the major societal challenges is the demographic change coming along with the ageing of the population. The increasing life expectancy observed over the last decades underlines the importance to find ways to appropriately cover the financial needs of the elderly. A particular issue arises in the area of health, where sufficient care must be provided to a growing number of dependent elderly in need of long-term care (LTC) services. In many markets, the offering of life insurance products incorporating care options and LTC insurance products is generally scarce. In our research, we therefore examine a life annuity product with an embedded care option potentially providing additional financial support to dependent persons. To evaluate the care option, we determine the minimum price that the annuity provider requires and the policyholder’s willingness to pay for the care option. For the latter, we employ individual utility functions taking account of the policyholder’s condition. We base our numerical study on recently developed transition probability data from Switzerland. Our findings give new and realistic insights into the nature and the utility of life annuity products proposing an embedded care option for tackling the financing of LTC needs.

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

The Unusual Cruelty of Nursing Homes Behind Bars

2020 ◽  
Vol 32 (5) ◽  
pp. 264-271
Author(s):  
Rachel E. López
Keyword(s):  
Nursing Homes ◽  
Human Dignity ◽  
Prison Population ◽  
Financial Burden ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Trained Staff ◽  
State Prisons ◽  
The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

Status and Degree of Dysphagia in the Elderly-A Comparison Study of Long-Term Care Elderly People in an Outpatient Clinic

2003 ◽  
Vol 54 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Masanori Komatsu ◽  
Kayoko Hirata ◽  
Idumi Mochimatsu ◽  
Kazuo Matsui ◽  
Hajime Hirose ◽  
...  
Keyword(s):  
Elderly People ◽  
Outpatient Clinic ◽  
Long Term Care ◽  
The Elderly ◽  
Comparison Study ◽  
Term Care

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

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