The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #58407

Jennifer Gillespie, MA and Neva Kaye. National Academy for State Health Policy, 50 Monument Square, Suite 502, Portland, ME 04101, 207.874.6524, jgillespie@nashp.org

The cost and prevalence of chronic conditions are disproportionately burdensome for people over 65. Among people age 65 and older, 62 percent have two or more chronic conditions. By age 80 and older, 70 percent have two or more chronic conditions. A chronic condition is defined as one that is likely to last more than one year, limits a person’s activities, and may require ongoing medical care. People with five or more chronic conditions average 15 physician visits and fill almost 50 prescriptions in a year.

Care for people with chronic conditions consumes 78 percent of all health care spending because people with chronic conditions use more hospital care, physician services, prescription drugs, and home health visits than people without chronic conditions. Among the Medicaid population, the costs are more than double, and for people age 65 and older who are dually eligible for Medicare and Medicaid, costs are more than five times higher. Out-of-pocket spending also increases with the number of chronic illnesses, especially among those 65 and older, of whom 27 percent had no prescription drug coverage in 1998. National research found that 23 percent of community dwelling elderly patients in the US received at least 1 of 33 potentially inappropriate (Beers List) medications.

Disease management and joint purchasing initiatives are among the strategies that have emerged to improve the quality of care for chronically ill seniors, increase their access to prescription drugs, and contain the costs.

Learning Objectives:

Individuals who attend this session will better understand:
• The prevalence and cost of chronic conditions among the over 65 population;
• The significance of the cost and use of prescription drugs among this population; and
• Approaches to improving access and containing costs of prescription drugs including disease management and joint purchasing.

Keywords: Chronic Diseases, Prescription Drug Use Patterns

Related Web page: www.nashp.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Partnership for Solutions, Johns Hopkins University and Agency for Healthcare Research and Quality
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.