Date:
04/14/2008 01:52 PM Medical care system not ready for mass of aging baby
boomers, study says
By RANDOLPH E. SCHMID
AP Science Writer
WASHINGTON
(AP) _ Millions of baby boomers are about to enter a health
care system for seniors that not only isn't ready for them,
but may even discourage them from getting quality care.
"We
face an impending crisis as the growing number of older patients,
who are living longer with more complex health needs, increasingly
outpaces the number of health care providers with the knowledge
and skills to care for them capably," said John W. Rowe,
professor of health policy and management at Columbia University.
Rowe
headed an Institute of Medicine committee that released a
report Monday on the health care outlook for the 78 million
baby boomers about to begin turning 65.
The
report from the institute, an arm of the National Academy
of Sciences, said:
—There
aren't enough specialists in geriatric medicine.
—Insufficient
training is available.
—The
specialists that do exist are underpaid.
—Medicare
fails to provide for team care that many elderly patients
need.
The
study said Medicare may even hinder seniors from getting the
best care because of its low reimbursement rates, a focus
on treating short-term health problems rather than managing
chronic conditions and lack of coverage for preventive services
or for health care providers' time spent collaborating with
a patient's other providers.
The
American Medical Association responded that seniors' access
to Medicare in coming years "is threatened by looming
Medicare physician payment cuts."
"This
July, the government will begin steep cuts in Medicare physician
payments, and 60 percent of physicians say this cut will force
them to limit the number of new Medicare patients they can
treat," the AMA said in a statement.
AARP,
the organization for older Americans, said the report highlights
the growing need for immediate action to improve and strengthen
the health care and long-term care work force.
"We
know the problem, and we know how to begin to fix it,"
said AARP President-Elect Jennie Chin Hansen.
The
group said it is endorsing a bill by Sens. Senators Barbara
Boxer, D-Calif. and Susan Collins, R-Maine, intended to steer
caregivers towards geriatric and long-term care roles, and
create an advisory panel to analyze this critical sector and
make recommendations to tackle its changing needs.
The
report found there are about 7,100 doctors certified in geriatrics
in the United States, one per every 2,500 older Americans.
Turnover
among nurse aides averages 71 percent annually, and up to
90 percent of home health aides leave their jobs within the
first two years, the report said.
But
while today's elderly tend to be healthier and live longer
than previous generations, people over 65 to have more complex
conditions and health care needs than younger folks.
The
report urged that all health care workers be trained in basic
geriatric care and that schools increase training in the treatment
of older patients.
The
federally required minimum number of hours of training for
direct-care workers should be raised from 75 to at least 120,
the report said, noting that more training is required for
dog groomers and manicurists than direct-care workers in many
parts of the country.
And
it said pay for geriatric specialists, doctors, nurses and
care workers needs to be increased.
A
doctor specializing in elderly care earned $163,000 on average
in 2005 compared with $175,000 for a general internist, even
though the geriatric specialist required more training.
The
report also urged training for family members and other informal
caregivers who assist the elderly.
The
study was sponsored by the John A. Hartford Foundation, Atlantic
Philanthropies, Josiah Macy Jr. Foundation, Robert Wood Johnson
Foundation, Retirement Research Foundation, California Endowment,
Archstone Foundation, AARP, Fan Fox and Leslie R. Samuels
Foundation and Commonwealth Fund.
The
National Academy of Sciences is an independent organization
chartered by Congress to advise the government on scientific
matters.
