People use health care services for many reasons: to cure illnesses and health conditions, to mend breaks and tears, to prevent or delay future health care problems, to reduce pain and increase quality of life, and sometimes merely to obtain information about their health status and prognosis. Health care utilization can be appropriate or inappropriate, of high or low quality, expensive or Inexpensive. The study of trends in health care utilization provides important information on these phenomena and may spotlight areas that may warrant future in-depth studies because of potential disparities in access to, or quality of, care.
Trends in utilization may also be used as the basis for projecting future health care needs, to forecast future health care expenditures, or as the basis for projecting increased personnel training or supply initiatives. The health care delivery system of today has undergone tremendous change, even over the relatively short period of the past decade. New and emerging technologies, including drugs, devices, procedures, tests, and imaging machinery, have changed patterns of care and sites where care is provided.
The growth in ambulatory surgery has been influenced by improvements in anesthesia and analgesia and by the development of noninvasive or minimally invasive techniques. Procedures that formerly required a few weeks of convalescence now require only a few days. New drugs can cure or lengthen the course of disease, although often at increased cost or increased utilization of medical practitioners needed to prescribe and monitor the effects of the medications.
Over the past decade, both public and private organizations have made great strides in identifying causes of disease and disability, discovering treatments and cures, and working with practitioners to educate the public about how to reduce the incidence and prevalence of major diseases and the functional limitations and discomfort they may cause. Clinical practice guidelines have been created and disseminated to influence providers to follow recommended practices. Public education campaigns urge consumers to comply with behavioral recommendations (e. g. , exercise and lose weight) and treatment regimens (e.
g. , take your medications) that may help to prevent or control diseases and their consequences. Health care utilization also has evolved as the population’s need for care has changed over time. Some factors that influence need include aging, sociodemographic population shifts, and changes in the prevalence and incidence of different diseases. As the prevalence of chronic conditions increases, for example, residential and community-based health-related services have emerged that are designed to minimize loss of function and to keep people out of institutional settings. Aging
The median age of the world’s population is increasing because of a decline in fertility and a 20-year increase in the average life span during the second half of the 20th century. These factors, combined with elevated fertility in many countries during the 2 decades after World War II (i. e. , the “Baby Boom”), will result in increased numbers of persons aged ;65 years during 2010–2030. Worldwide, the average life span is expected to extend another 10 years by 2050. The growing number of older adults increases demands on the public health system and on medical and social services.
Chronic diseases, which affect older adults disproportionately, contribute to disability, diminish quality of life, and increased health- and long-term–care costs. Increased life expectancy reflects, in part, the success of public health interventions, but public health programs must now respond to the challenges created by this achievement, including the growing burden of chronic illnesses, injuries, and disabilities and increasing concerns about future caregiving and health-care costs. This report presents data from the U. S. Bureau of the Census, the World Health Organization, and the United Nations on U.
S. and global trends in aging, including demographic and epidemiologic transitions, increasing medical and social costs related to aging, and the implications for public health. In the United States, the proportion of the population aged ;65 years is projected to increase from 12. 4% in 2000 to 19. 6% in 2030. The number of persons aged ;65 years is expected to increase from approximately 35 million in 2000 to an estimated 71 million in 2030, and the number of persons aged ;80 years is expected to increase from 9. 3 million in 2000 to 19. 5 million in 2030.
In 1995, the most populous states had the largest number of older persons; nine states (California, Florida, Illinois, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Texas) each had more than one million persons aged ;65 years. In 1995, four states had ;15% of their population aged ;65 years; Florida had the largest proportion (19%). By 2025, the proportion of Florida’s population aged >65 years is projected to be 26% and >15% in 48 states (all but Alaska and California). The sex distribution of older U. S. residents is expected to change only moderately.
Women represented 59% of persons aged >65 years in 2000 compared with an estimated 56% in 2030. However, larger changes in the racial/ethnic composition of persons aged >65 years are expected. From 2000 to 2030, the proportion of persons aged >65 years who are members of racial minority groups (i. e. , black, American Indian/Alaska Native, Asian/Pacific Islander) is expected to increase from 11. 3% to 16. 5%; the proportion of Hispanics is expected to increase from 5. 6% to 10. 9%. The world has experienced a gradual demographic transition from patterns of high fertility and high mortality rates to low fertility and delayed mortality (2).
The transition begins with declining infant and childhood mortality, in part because of effective public health measures (2). Lower childhood mortality contributes initially to a longer life expectancy and a younger population. Declines in fertility rates generally follow, and improvements in adult health lead to an older population. As a result of demographic transitions, the shape of the global age distribution is changing. By 1990, the age distribution in developed countries represented similar proportions of younger and older persons. For developing countries, age distribution is projected to have similar proportions by 2030.
People are living longer because of both lifestyle changes and advances in health care. For example fewer people smoke today than in the past. In the 1950’s more than half of men and a third of women smoked cigarettes. By 2005, those numbers were down to 23 percent of men and 19 percent of women. Thanks to major advances in medicine, fewer people die at an early age from heart disease and cancer. For example the five year cancer rate improved from 50 percent in the mid 70’s (1975-1977) to 66 percent at the turn of the 21 century (1996-2002).
With increased longevity , Boomers will reach retirement age, have more years to enjoy it and , in turn , more years in need of health care services. Diabetes The number of Americans with diabetes is expected to rise from 30 million today to 46 million by 2030, when one of every four Boomers -14 million-will be living with the chronic disease. These diabetic Boomers will require continuous medical management in both inpatient and outpatient settings. Arthritis The number of Americans with arthritis is expected to rise from 46 million today to 67 million by 2030.
At that point, nearly one out of every Boomers-over 26 million-will be living with the condition. While health risk of arthritis are not as great as other chronic illnesses, the decrease mobility arthritis can trigger will cause many Boomers to seek new alternative therapies, pain control treatments, exercise regimens and joint replacements. Obesity If America’s obesity trend continues at its current pace, all 50 states could have obesity rates above 44 percent by 2030 according to a new report from Trust for Americans’ Health and the Robert Wood Johnson Foundation. With current U.
S. obesity rates holding steady around 35 percent — that’s one-third of Americans — the 9-plus percent gain within two decades would be a significant increase; however, not as large of an increase as the nation has seen in the past two decades. While the health hazards are apparent — the report projects double the number of new cases of obesity-related ailments like diabetes, heart disease hypertension by 2030 — the increase in American obesity would also take a toll on the healthcare system itself. Current estimates put the medical costs of obesity at more than $147 billion.
With increasing rates, the costs of preventative healthcare relating to obesity would rise by $48 billion to $66 billion in the next two decades. Many Americans aren’t very physically active. One reason for this is that many people spend hours in front of TVs and computers doing work, schoolwork, and leisure activities. In fact, more than 2 hours a day of regular TV viewing time has been linked to overweight and obesity. Other reasons for not being active include: relying on cars instead of walking, fewer physical demands at work or at home because of modern technology and conveniences, and lack of physical education classes in schools.
People who are inactive are more likely to gain weight because they don’t burn the calories that they take in from food and drinks. An inactive lifestyle also raises your risk for coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems. Our environment doesn’t support healthy lifestyle habits; in fact, it encourages obesity. Some reasons include: (1) Lack of neighborhood sidewalks and safe places for recreation. Not having area parks, trails, sidewalks, and affordable gyms makes it hard for people to be physically active.
(2) Work schedules. People often say that they don’t have time to be physically active because of long work hours and time spent commuting. (3) Oversized food portions. Americans are exposed to huge food portions in restaurants, fast food places, gas stations, movie theaters, supermarkets, and even at home. Some of these meals and snacks can feed two or more people. Eating large portions means too much energy IN. Over time, this will cause weight gain if it isn’t balanced with physical activity. (4) Lack of access to healthy foods.
Some people don’t live in neighborhoods that have supermarkets that sell healthy foods, such as fresh fruits and vegetables. Or, for some people, these healthy foods are too costly. (5) Food advertising. Americans are surrounded by ads from food companies. Often children are the targets of advertising for high-calorie, high-fat snacks and sugary drinks. The goal of these ads is to sway people to buy these high-calorie foods, and often they do. Part of the reason for the rise in the obesity rate is the changing demographics of the U. S. population.
The baby boomer generation is aging. With aging comes a decrease in activity. If you are less active, the calories you take in can mean the difference between being lean and being obese. It is all about a balance between diet and fitness. Biology also works against you. With the loss of muscle mass, you burn fewer calories. Menopause also sets up a scenario where women in this age bracket put on a few pounds. However, according to Mayo Clinic, you don’t have to follow the path of age-related weight gain. You have control over your activity.
If you stay active, you can maintain the balance between the fuel your muscles use and your caloric intake. Unfortunately, the media teaches people that being overweight is not something for which to be ashamed. However, being fat is not okay. It is unhealthy and not something that can be dealt with by trendy fashions or slimming panels. The only solution is to lose weight. Otherwise, you will likely fall prey to the health risks of those added pounds. They can take months or years off your life. Losing weight is not an option; it is a necessity.
Health » With the rise in heart disease and diabetes, the medical field has been forced to consider the main causes of obesity in America in order to halt the alarming trends of this health epidemic. If you are overweight or obese, it behooves you to find ways to get your weight under control in order to avoid the consequence of excessive weight. Part of the reason for the rise in the obesity rate is the changing demographics of the U. S. population. The baby boomer generation is aging. With aging comes a decrease in activity.
If you are less active, the calories you take in can mean the difference between being lean and being obese. It is all about a balance between diet and fitness. Biology also works against you. With the loss of muscle mass, you burn fewer calories. Menopause also sets up a scenario where women in this age bracket put on a few pounds. However, according to Mayo Clinic, you don’t have to follow the path of age-related weight gain. You have control over your activity. If you stay active, you can maintain the balance between the fuel your muscles use and your caloric intake.
Unfortunately, the media teaches people that being overweight is not something for which to be ashamed. However, being fat is not okay. It is unhealthy and not something that can be dealt with by trendy fashions or slimming panels. The only solution is to lose weight. Otherwise, you will likely fall prey to the health risks of those added pounds. They can take months or years off your life. Losing weight is not an option; it is a necessity. The fact remains that fat tastes good. It gives you a satisfying feeling. It is the epitome of comfort food.
If you want to lose weight, it is up to you to break the fat addiction, which is one of the main causes of obesity in America. At the simplest level, added weight makes your heart work harder. You may huff and puff going up the stairs or even walking across the room, if you lug around an extra 30 to 40 pounds. If you have tried to lift a heavy suitcase or other load that size, you know how difficult toting the added weight can be. Imagine carrying around that excess baggage 24/7. Obesity feeds upon itself. As you gain weight, it becomes more difficult to move around.
Your muscles ache. You become easily fatigued. Your inactivity causes you to increase weight. This vicious cycle is one of the main causes of obesity in America. In order to overcome it, you must break this cycle of inactivity. Being obese increases your risk of several chronic health conditions including heart disease, high blood pressure and diabetes The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. If you are overweight, reducing your weight by 5%-10% is proven to decrease your chance of developing heart disease.
Fortunately, even a modest weight loss of 10 to 20 pounds can bring significant health improvements, such as lowering one’s blood pressure and cholesterol levels You can reduce your risk of developing type 2 diabetes by losing weight, eating a balanced diet, getting adequate sleep, and exercising more. If you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels. Increasing your physical activity may also allow you to reduce the amount of diabetes medication you need. Future
There will be some very disruptive and some transformational changes in the way health care is delivered, not as a result of reform, but as a result of the drivers of change described in a previous post on KevinMD. com. They included an aging population, an obese society, shortages of doctors, and emerging consumerism, among others. There will be many more patients needing substantial levels of medical care. These won’t be just any patients but two specific groups that are growing rapidly. Americans are aging. “Old parts wear out” and there are certain diseases that become more prevalent with age like Alzheimer’s and osteoarthritis.
And of course our society has many adverse lifestyles such as consuming too much of a non-nutritious diet, being sedentary, being chronically stressed and 20% still smoke. These all lead to chronic illnesses like diabetes type II, heart failure, cancer, chronic lung and kidney disease, etc. So there will many more individuals with chronic illnesses. The especially sad thing is that many of these individuals will be moderately young as a result of obesity since one third are overweight and another one third are frankly obese. This increase in chronic diseases and diseases of aging will have huge impacts on care delivery.
Health care delivery will help obesity related issues by educating obese clients the proper diet and food intake and how important exercise to lose weight. The health team can discuss patients on the effect to the body . the serious disease that they can get being obesed. they can guide them in their food intake and control and help them lose weight. As for age related health issues- health teaching is the best way to inform patients to diseases that is related to age. The team can help them be aware and give them preventive measures for the age related diseases.