This brief factsheet by Dr. David Hornick
provides selected facts and figures for a broader discussion of the community
ramifications of the crisis in chronic care in the Captial Area.
- The homebound chronically ill elderly receive
only one doctor visit on average every two years - -
in comparison to 11 visits per year for those who are ambulatory and to 6-to-12 visits per year for
those who are in nursing homes.
- The cost for caring for people in nursing homes
is an average of approximately $50,000 per year in New York State. Medicaid is
the primary funder of nursing home costs with counties paying 15 percent or
$7,500 per year for every Medicaid nursing home recipient.
- A recent study of nursing homes in Schenectady
county identified 50 people who were probably inappropriately placed and could
have, more appropriately, been cared for at home in the community. The total
cost of their care to the county is approximately $375,000 PER YEAR.
- Based on the 1990 Census, approximately 10
percent of the aged 65-plus populations of Albany and Schenectady counties were
homebound - - 4,200 of 42,820 aged
65-plus in Albany county and 2,500 of
24,711 aged 65-plus in Schenectady county.
- In the eleven counties of the Capital Area, the
1990 Census identified 52,536 people aged 16-plus with mobility or self-care
limitations including 28,695 or 19 percent of the aged 65-plus
non-institutional population. Those with self-care limitations numbered 33,378
aged 16-plus including 16,661 or 11 percent of the aged 65-plus.
- People receiving home health care services are
increasing at a faster rate among the aged 85-plus than among the under 65
population. Nationally, the number of people aged 85 and older receiving home
health care will grow from 197,276 in 1980 to a projected 450,462 in the year
2000, a 128 percent increase. At the same time, the number under 65 years old
will increase by 25 percent from 759,680 in 1980 to 947,305 in the year
2000.
- Epidemiological studies have revealed that more
that 40 percent of people 85 years of age and older have lost the ability to
perform one-or-more of the activities of daily living, e.g., the self-care
activities of bathing, eating, dressing and getting around inside the
home.
It is clear that chronic disease resulting in
reduced functional capacity and inability to leave the home has increased and
will continue to grow over the next 30 years as the "Baby Boomers"
reach old age.
What is not clear is whether the public health
community and other sectors of society are prepared to adequately meet this
crisis.
Dr. David Hornick, April 1999
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