H220 - Basic Concepts II

normal aging

time dependent series of cumulative, progressive, intrinsic, and harmful changes that manifest at reproductive maturity and end in death

primary aging

changes independent of disease/trauma

secondary aging

changes from disease/trauma

mortality

death

morbidity

condition/disease

manufactured time

length of life with disability

technology keep them alive

epidemiology

study of epidemics

use of statistical techniques - epidemiology

study distribution of disease in human populaiton

goal of epidemiology

understand diseases common among older people and assess impact

chronic conditions

most common cause of death in older population

1 chronic condition 65+

80%

2+ chronic conditions older population

50%

co/multi morbidity

multiple chronic conditions

1965

social security act creates medicare

4 things medicare doesn’t cover

1st day of hospitalization

hearing aid

eyeglasses

dental

how much does medicare cover

50% out of pocket

medigap

secondary insurance plan that covers what medicare can’t

4 parts of medicare

Hospital insurance

Medical insurance

medical advantage

prescription drugs

Part A Hospital Insurance

inpatient hospital stays, hospice, skilled nursing facility

Part B Medical Insurance (3 services, 1 other thing)

doctor visits, outpatient hospital stays, medical equipment

monthly income premium

Part C Medicare Advantage

mainly private insurance

Combine A, B, and D, include extra benefits

How is Part A Medicare primarily financed?

payroll tax as part of social security tax

levied on all wages up to a specific limit

Prospective Payment System 1983

hospitals receive fixed amount per diagnosis regardless of the service/stay

Diagnosis Related Groups (DRG)

diagnostic categories

resource based relative value scale 1989

primary health care providers pay more for services

incentivize specialties like prevention instead of life prolonging technology

65+ stat

5% in nursing home.

5% in other facility

85+ statistic

25% live in special/supportive housing

continuing care retirement communities

housing and healthcare

domiciliary care facilities/broad and care homes

custodial or personal care for ADL needs

assisted living facilities

home environments with personal supportive care

Section 202+8 *housing programs)

subsidized rental housing with no social or health support

congregate housing

residential facility for independent elders

shared housing

alternative group with shared common area arrangement

nursing home

residential facility with a little nursing care

40%

amount of 65+ people who will spend time in a nursing home

continuum of care

keep people out of nursing homes

3 self determined death factors

terminatino of treatment

active euthanasia

assisted suicide

altruistic su!icide

self sacrifice for sake of others (going into woods yourself and freezing)

anomic su!icide

derived feeling of hoplessness