Introduction
The rate of mortality of the elderly in the society has reduced over the years. There is also the evidence of the health of the people improving. There has been a notable rise in the demand for proper healthcare especially for the people who are on Medicare. The life expectancy of the elderly has even improved as people now live for longer periods of time (Fussel, 2004). Additionally, it is exceptionally critical to note that the cost that one endures when trying to maintain their healthcare costs have significantly gone up. A person who is in better health would spend less on healthcare as compared with another person on the same age bracket but poorer health. The multistate life table methods were used to ensure that the demographic variables were linked to the health status of the individual in the various states.
METHODS
Selection of Data
The scientific survey was executed to investigate the health of the people over the ages of 65. The survey represented the entire population since it also included people who were institutionalized and had to receive medical care for these institutions. These are mostly the aged people who are not able to take good care of themselves and also do not have families to take care of them. The survey found out that the elderly people were the ones who received the most medical care from the hospitals. Furthermore, they were more knowledgeable on the issues that affected them and were keen on what type of medication that they would be prescribed. It is important to note than they were able to understand even the small details of what was recommended due to more literacy. The amount of money that is used to treat such patients increases by the day. The use of Medicare was appropriate since it is the means through which most patients pass through. The expenses that were used to reimburse the services and information about the deaths are directly taken for the records of Medicaid. The data was obtained from the claims that were made by the respondents and their families. It is the most accurate method since all the sick people get through this type of system.
The program started on the where data was collected and replaced each and every year. People who did not opt out if the research or die during the research period is expected to avail themselves in the interviews and the questionnaires. For the one who die while they are not under-estimated but rather are included in the research findings of the study. The rate or percentage response of the survey was 70%.
The research was limited to people were over 70 years so as to reduce cases of bias. It is because the people who enrolled for Medicare when they were between the ages of 65-69 were not eligible for the study. The total number of people interviewed was 16,964 years. The health status of the respondents was based on the answers given about various activities. These measures are the same ones that are usually used for the elderly people in the society. The activities include crouching, kneeling, lifting and carrying objects that weigh up to six kilograms and finally extending their arms above their shoulders. The participants were then asked to clearly rate the level of difficulty that they experienced when carrying out such activities. The people who found it difficult to carry out the activities were rated as people with limited physical functioning. Other activities that were used to rate the people included using the telephone, doing light chores in the household and preparing their food. The study classified the people who had trouble doing such as having a restriction in performing a particular action. The state of health was defined as not having any trouble in performing any of the duties. The study reported 15,278 changes in the health status of the respondents and an occurrence of 3462 deaths among the respondents as well.
Active life was defined as one that did not have any limitations, and the respondents could do all the things without any help. It was noted that the people who lived in the institutions required more help than the rest of the population and they needed assistance on almost all the activities of the day.
Literature review
The elderly people are marked by a number of diseases and disabilities that affect them in their old age. For instance, old people are prone to getting diseases such as arthritis and other mental illnesses. Most families can barely afford to take care of the patients on their own and therefore resort to taking them to homes where they can be cared for. Elderly people first lose their memories. It is quite difficult for them to recall everything that was sometimes done even just minutes earlier. They have to be continually aided to do things all the time and sometimes even forget the names of the people that they are close to. It is because their brain function decreases as the time passes by. They are not in the proper position to recall even the basic things that are important to them.
Another issue is that they lose their sensitivity in their sensory organs. For instance, they lose their sense of hearing. Many of them have to be shouted to in order to enhance communication. Their sense of smell also declines as they barely can smell the people around them and the food that is being cooked. Their sense of sight also declines. They usually have trouble in identifying things and seeing things that are far off.
Their brain function decreases and they are at a higher risk of getting illnesses such as Alzheimer and schizophrenia where they can barely remember the people around them. They, in most cases, have to have people to take care of them and at times even the family members, loved ones or the next of kin cannot take care of them. The family members sometimes take the elderly people to the institutions because they need to be taken care of by specialized care. The elderly usually have to leave their homes and get care from the people who are qualified enough to take care of them. The families usually have to take care of the expenses. The elderly people also have poor functioning of their body organs. For instance, their bladders at times loosen, and they are unable to control their wastes from coming out. This means that they also in some ways lose their self-respect and also suffer from the psychological distress. They are unable to do the things that they could do before with so much ease.
Furthermore, they are sidelined by the society since they can no longer effectively execute things that they could do before comfortably. The loss in their independence takes a toll on them. The transition from being able-bodied to people who cannot depend on themselves is a big blow to deal with and most of them even become depressed because of them. At an advanced age, they are susceptible or vulnerable to getting opportunistic ailments such as diabetes and hypertension. They have an unreliable immune system due to the old age. They are also prone to getting infectious diseases much faster than the normal population because of a weakened immune system could do things on their own, and now they have to rely on other people to do for them even their most basic needs. As people grow older, their health declines. This is evidenced by the amount of insurance they have to pay for their health. Reports show that older people attend the hospitals much more than the younger population. It is because of an unreliable immune system. This means that they have to be performed surgery on; they have to take drugs to sustain their bodily functions and sometimes even need organ donations for those that have failed completely such as the kidneys. They are also less tolerant to the drugs that are given to them. They have to be given mild drugs since the drugs that are given to them can easily have a negative effect on them by being too strong for their frail health.
RESULTS
The research that was carried out postulated that the people who were over 70 years of age, only thirty percent of the population reported functional limitations of their activities. About 42% of the people had nag limitations. 18% had difficulties in carrying out their day to day operations, and only two percent of the population had been confined in an institution. At seventy years of age, they all expected to live for at least 13.2 years/. Of the seventy years. Only fifty-two years could be used for an active lifestyle and two years used for moving from place to place, until they passed on at the age of 70. The expenditure of the people for the people at this age was very high since they had to be subjected to institutionalized care for a number of times. Furthermore, the expenditures on the men were much higher than in the women. Women also had a higher life expectancy than the men of the respondents that were interviewed. There were no differences among the black and the whites although the blacks were expected to live for fewer years than their white counterparts. This goes to show that the black people may at times not have the same opportunities that the white people have.
The costs that were incurred when the individual was accounted for a large part of the financial burden. It is because they spent the last part of their lives living with limitations that means that more financial resources will have to be directed to them for their daily survival. Of the total costs that are incurred it means that more and more money will be spent on the medical facilities of the aged people.
Approximated figures of Health Care Expenditures and Life Expectancy in accordance to Health Status
People with better health at the age of seventy years were expected to live for longer than people with poor health. People who had no limitations in their activities meaning that they could crouch, bend and run their duties without any difficulties were expected to live longer than the people who had difficulties in maintaining their balance and carrying out their daily activities. The people who had better health were also expected to have longer active lives than their counterparts who had difficulties in maintaining their daily activities. The more that, the older person relies on the people around him, the more indicative it is of their health. People were expected to have better life standards when they were more active and could do things for themselves in a more confident manner than in people who had extreme difficulty in doing things for himself. The more difficulty that the individual showed in carrying out their activities, the poorer health they were considered to have.
The people who lived in a community were rarely placed in an institution than people who live in their homes. It is because they have people to take care of them and to care for their needs. Furthermore, they were expected to spend only a small amount of time in the institutions. People who lived near their families benefit from the care that is given to them, and they can live for longer. Those that were widowed with no children showed the most disabilities since they did not have any support. They had higher chances of being placed in an institution. In the same way, people who lived in the institutions were reported to have a shorter life than the ones who spent them with their family and friends. They are reported to be happier than the ones who were confined in the institutions. A familiar background gives them peace of mind. Being near family and friends enable them to interact freely with the rest of the population.
The individuals who did not experience ill health at the age of 70 and lived longer did not incur extra health care costs. The individuals who were in good health and without any limitation incurred a total of $136,000 in health care expenditures from age 70 until death. On the other hand, the individuals with functional limitations spent an estimated $145,000 on health care. The higher expenditures exhibited by some 70-year-olds was because of the consequences of paying the fees of the nursing home.
When the differentiation of the people comes to the functional state of the various individuals, and no special category for the people who are confined in the institutions, both having difficulty in performing their daily activities and also have greater life expectancies. However, there was very little difference on the amount of financial resources that were spent on them. It is because it took more to maintain them and to ensure that they are doing well. In the same way, after seventy years of age, there was very little difference in the amount of funds that was spent to treat them when they got sick and although there were no differences in the length of time that they lived after that.
DISCUSSION
In order to estimate the relationship between health, longevity and expected health care spending, the existing health care data was linked to the estimates of the 70-year-old individual’s life expectancy. From the analysis done thereafter, it was evident that the individuals who enjoy good health at the age of seventy had a greater chance of living a longer life as compared to those who are seventy years and are of poor health. Furthermore, it is observed that the total health care expenses of the healthy 70 year olds is similar to the health care expenses of the 70 year old who are of poor health, even though the healthier individuals outlive the unhealthy ones. An earlier report showed that the lower health care costs paid by the healthy 70-year-olds offsets, the longer time they have to accumulate their health care costs. Some results of earlier studies suggest that the possibilities of a better health among the elderly will lead to a reduced and moderate spending on health care (CDCP, 2002).
This study faces many limitations. The first limitation is the period that the age-specific probability of change was employed to produce the estimates. The period chose from 1992 to 1998. A lot of data has changed over time, and it might not correctly represent the actual situation on the ground. Secondly, there are some changes in health care, social and demographics that were left out in the process. For instance, there are many changes that occur in regard to long term health care. These changes include a decrease in size of the informal health care and an increase in the number of paid health care. It is not out rightly clear how the changes that occur will affect the costs associated with institutionalization, since it is a major cost in the treatment of the elderly. Care should thus be taken when giving projections into the future.
A third limitation is that the life-table technique assumes a first-order Markov process. The assumptions do not take into account the relationship between the current and past health statuses. It is only concerned with the preceding state. A fourth limitation is the weakness of employed measures to capture other forms of health as cognitive or emotional health. The fifth limitation is that the analysis carried only capture the formal health care and left out informal health care. In some instances, the informal health care is costly for the family members.
This study clearly shows that the elderly who enjoy better health live a longer life with low health care expenditures. However, more scientific surveys need to be done in order to put into perspective the cost that is involved when an individual spends money on health care before they attain the age of 70.
At this point, it is not quite clear what the future trends of the elderly health care hold. Elderly person are picking up trends and habits such as smoking and education. The change in lifestyle increases the risks of lifestyle diseases (Abma, 2002). It was believed that the patterns found in the study suggest that health-promotion endeavors in the youthful part of the populace that have payoffs in flamboyant health and longer life for the aged will not increase health care dedicated funds among the elderly.
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