Who will pay the costs for heath care for the elderly ?
Dependency ratios are an indicator of the potential burden on those in the working-age population .
|
Population aged 65years and over |
|
Old age dependency = |
———————————————— |
X 100 |
|
Population aged 20-64 years |
|
Between 2010 and 2030 , the old-age dependency ratio will increase rapidly as the population of baby boomers moves into the 65 years and over category . The realities are :
• Greater numbers of older individuals will be dependent upon smaller numbers of working age persons to provide the financial support for health care services .
• The smaller working age population will need to continue its support for youngsters under twenty years of age . 16
As to actual costs for health care , in 2006 the average annual expenditure for the major components of health care among Medicare enrollees increased with age , from $ 11,300 for the 65-74 age group to $ 23,700 for the 85 years and older population . 17 Elderly persons in better health have a longer life expectancy than those in poorer health but have similar cumulative health care expenditures until death . A person with no functional limitation at 70 years of age has a life expectancy of 14.3 years and expected cumulative health care expenditures of about $ 136,000 ( in 1998 dollars ). A person with a limitation in at least one activity of daily living has a life expectancy of 11.6 years and expected cumulative expenditures of about $ 145,000 . Persons who are institutionalized at the age of 70 have cumulative expenditures that were much higher than those for persons who were not institutionalized . 18
Comments
The use of mega numbers and proportions is important to provide a general perspective , but more local and individual impact considerations afford a personal understanding for health providers and the general public to derive an appreciation of the developing realities when one-in-five residents of this country will reach the milestones of older age .
As to the particular perspective of the dental practitioner , given the continuing decrease in edentualism rates , 19 the average elderly patient ( with the anticipation of a potential increase in life expectancy ) is expanding the use of dental services . Note : in 2008 , Pennsylvania ranked 25th with 18.3 percent of the elderly reported to be edentulous . Hawaii was ranked 1st with a 9.8 percent rate of edentulism for the elderly ; West Virginia was ranked 50th with a 37.8 percent rate of edentulism . Nationally , the rate of edentulism for the elderly was 18.5 percent . 20
The need exists to comprehend the physical , psychological , economic , family conditions and a seeming endless array of related factors which affect older patients . But the reality is that despite the many changes as individuals age , the limited availability of dental insurance , and economic difficulties , they increasingly are reporting the use of dental services . The question remains , is your practice prepared for the increasing numbers of elderly coming to your neighborhood ?
About the Authors
Dr . Waldman is a Distinguished Teaching Professor in the Department of General Dentistry at Stony Brook University , NY .
Dr . Cannella is Director of Behavioral Sciences in the Department of General Dentistry at Stony Brook University , NY .
Dr . Perlman is Global Clinical Director , Special Olympics , Special Smiles and Clinical Professor of Pediatric Dentistry at the Boston University Goldman School of Dental Medicine .
J A N / F E B 2 0 1 3 | P E N N S Y LVA N I A D E N TA L J O U R N A L 3 5