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Does It Matter How You Slice It? The Relationship Between Population Ageing and Use of Hospital and Posthospital Care in the United States

Published online by Cambridge University Press:  14 November 2008

Andrea Steiner
Andrea Steiner
Affiliation:
Institute for Health Policy Studies, University of Southampton, Southampton SO171BJ, UK.
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Abstract

In the context of demographic transition, one would expect public health planners to allocate resources according to changing needs. This paper explores the effects that definitions of population ageing have on the images of, and subsequent responses to, demographic transition in the United States. Data are drawn from the 1988 U.S. Census and from a 20-percent national random sample of Medicare patients during the same period (n = 1.9 million). Main findings are that supply and use of acute services do differ according to definitions and the way in which population ageing has occurred; that, regardless of definition, older people in high-ageing states make far greater use of posthospital home health care than in low-ageing states; and that, although individual-level clinical factors appear central to rehabilitative decisions, all states seem to use very old age (85-plus) as a proxy to determine who goes where, with low-ageing states also affected by structural constraints at the hospital and market levels.

Keywords

Demographyhealth services planningMedicarestrokesocial burden of ageing.
Type
Research Article
Information
Ageing & Society , Volume 16 , Issue 2 , March 1996 , pp. 205 - 232
Copyright
Copyright Cambridge University Press 1996

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