Does age or life expectancy better predict health care expenditures?

It is an unresolved issue whether age or (expected) remaining life years better predicts health care expenditures. We first estimate a set of hazard models to predict life expectancy based on individual demographic characteristics and health conditions, and then use regression analyses to compare the predictive power of age and life expectancy in explaining health care expenditures. This paper differs from previous studies in that it uses predicted life expectancy to address the censoring of death; as a result, this paper goes beyond the large health care expenditures at the end of life and the results apply to both deceased and survivors. We find that age has little additional predictive power on health care expenditures after controlling for life expectancy, but the predictive power of life expectancy itself diminishes as health status measures are introduced into the model. These results are not of esoteric interest only for their statistical properties; we show that using life expectancy rather than age results in lower projections of future health care expenditures. This result suggests that increases in longevity might be less costly than models based on the current age profile of spending would predict.     

我国养老地产医疗配套服务发展探讨

我国人口年龄结构已进入老龄化阶段，促进老龄事业发展成为社会发展重大问题。养老地产及其医疗配套服务是为老社会服务的重要内容。但目前我国养老地产处于起步阶段，医疗配套服务水平参差不齐。本文通过对我国养老地产医疗配套服务现状的分析，借鉴国外养老医疗配套服务模式，提出完善我国养老地产医疗配套服务发展建议。     

人口老龄化背景下中国护理服务产业现状及其发展建议

通过在人口老龄化背景下预测中国护理服务需求，对比护理服务提供现状的差距，分析其中原因。在比较分析国内外发展护理服务应对人口老龄化经验的基础上，提出发展中国护理产业的构想及其在行业管理、经济补偿和人力资源等领域的政策建议。     

The Cost of an Additional Disability‐Free Life Year for Older Americans: 1992–2005

Objective

To estimate the cost of an additional disability-free life year for older Americans in 1992–2005.

Data Source

This study used 1992–2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design.

Study Design

This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes.

Principal Findings

Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups.

Conclusions

The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone.     

国外主要养老模式介绍

随着人口老龄化进程的加速,各种养老模式应运而生。据统计国内外的养老模式达20多种,主要分为以下几种类型:居家养老模式、社区养老模式、机构养老模式。本文对国外的主要养老模式进行综合分析,以期为我国养老模式的发展提供借鉴与启示。     

人口老龄化及口腔健康对策

中国的老龄化进程发展迅速，老年人口占总人口的比例逐年增高，老年口腔疾病的发病率也有所提高。口腔健康作为全身健康的一部分，对老年人的生活质量有着重要的意义。本文就中国人口老龄化的现状、人口老龄化对口腔健康及卫生保健的影响以及相关对策的研究进展作一综述。     

重视高龄老人冠心病诊治特点

中国已进入了老龄化社会,而人口老龄化的特点是高龄老人(≥80或≥85岁)数量增长迅速,高龄老人冠心病发病率也逐年增加。高龄老人冠心病因其临床特点有别于一般成人冠心病,易导致漏诊和误诊。我们应该关注和重视高龄老人这一特殊群体,基于循证医学依据,遵循临床指南,坚持个体化原则,积极控制多种冠心病的危险因素,针对高龄老人冠心病的临床症状和并发症特点,及时调整治疗方案,进一步延长患者寿命、减少冠心病心血管事件发生。     

发展老年护理服务产业体现护理报务的社会价值

老龄化社会已经到来，我国社会发展面临着巨大的公共服务包括医疗护理服务提供的挑战。我国存在着极具价值的、潜在的护理服务产业，但是，目前护理服务的补偿机制违背经济规律。应明确我国护理服务业的发展策略，制定产业政策，并据此形成相应的人力资源政策。     

Self-care ability and institutional/non-institutional care of the elderly

This paper discusses the relationship between demographic change, health status, self-care ability, and the needs of the elderly for medico-social care. The author introduces ASKORUSS, an instrument used to assess self-care ability and the need for assistance. ASKORUSS organizes the results of the assessment in a visually accessible and compelling way and can be used to determine the patient's needs for level of care, treatment, and rehabilitation. The instrument also can be used to evaluate the efficacy of an institution and its services, the outcomes of the care provided, as well as other purposes.     

人口老龄化对重庆市恶性淋巴瘤发病趋势的影响

目的 分析重庆市恶性淋巴瘤发病趋势变化及人口老龄化对发病趋势的影响,为开展恶性淋巴瘤防控工作提供建议。 方法 收集整理2006-2014年重庆市肿瘤登记点报告恶性淋巴瘤新发病例,统计分析发病率、中标率、世标率、年度变化百分比(annual percent change, APC),采用曲线估计指数分布回归模型进行趋势变化分析。采用差别分解法分析人口老龄化和其它影响因素对恶性淋巴瘤发病趋势变化的贡献率。 结果 重庆市恶性淋巴瘤发病率由2006年的2.31/10万上升至2014年的6.82/10万,APC为9.09%,变化趋势差异有统计学意义(P<0.05),中标率、世标率APC分别为5.34%与4.92%,变化趋势差异均无统计学意义(P>0.05)。恶性淋巴瘤发病率的上升受人口因素与其它影响因素的协同作用,其它影响因素的贡献率(72.45%)高于人口老龄化的贡献率(27.55%)。 结论 2006-2014年重庆市恶性淋巴瘤发病率呈上升的趋势,发病率上升受人口老龄化与其它影响因素的协同影响,应重视恶性淋巴瘤的一级预防工作。