Health care for the elderly. Who will pay for it and how?

Area of Science:

• Geriatric Medicine
• Healthcare Systems Analysis
• Health Policy

Background:

• Individual physicians can provide effective elderly care with adequate resources and reimbursement.
• Despite individual physician capabilities, the larger healthcare system often fails older patients.
• Existing healthcare models and policies require critical evaluation for their impact on geriatric care.

Purpose of the Study:

• To analyze the effectiveness of current healthcare systems in supporting elderly patient care.
• To evaluate the impact of specific policies like Diagnosis Related Groups and Health Maintenance Organizations (HMOs) on geriatric care.
• To explore potential improvements by examining alternative models such as Social HMOs, the Medicare Catastrophic Coverage Act, and Canada's long-term care system.

Main Methods:

• Critical review and analysis of existing healthcare policies and systems.
• Comparative assessment of healthcare delivery for elderly patients in the US and Canada.
• Exploration of the challenges faced by physicians in providing continuous care for older adults.

Main Results:

• The study identifies systemic deficiencies that impede comprehensive care for elderly patients.
• Diagnosis Related Groups, HMOs, Social HMOs, and the Medicare Catastrophic Coverage Act have shown limited success in fully addressing the needs of older patients.
• Canada's long-term care system presents a different model, offering insights into potential physician support.

Conclusions:

• The US healthcare system faces significant challenges in effectively supporting elderly patients and their physicians.
• A re-evaluation of healthcare policies and systems is necessary to ensure adequate resources and effective reimbursement for geriatric care.
• International comparisons suggest alternative approaches may offer better support for long-term elderly care.