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. 1990 Oct;25(4):639–665.

Morbidity and medical care utilization of old and very old persons.

R E Johnson 1, J P Mullooly 1, M R Greenlick 1
PMCID: PMC1065650  PMID: 2211132

Abstract

This report compares the morbidity, health care and drug utilization, and health status of random samples of HMO-enrolled Medicare beneficiaries ages 65-79, and 80 and over. The population represented 3,683 person-years of Kaiser Permanente eligibility (59.2 percent female). Those 80 and over were 20 percent of the person-years (64.1 percent female). The effects of age and sex on morbidity and utilization were analyzed using log linear models that controlled for eligibility, and using two-way analyses of variance of rates. Few differences were found in the morbidity experiences and utilization rates of the two age groups. Indicators of self-reported health status did differ. The findings support the idea that noninstitutionalized very old persons are the healthy survivors of their cohort. Their health care needs may not be much different than younger old persons in terms of the types and amounts of health care services needed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cornoni-Huntley J. C., Foley D. J., White L. R., Suzman R., Berkman L. F., Evans D. A., Wallace R. B. Epidemiology of disability in the oldest old: methodologic issues and preliminary findings. Milbank Mem Fund Q Health Soc. 1985 Spring;63(2):350–376. [PubMed] [Google Scholar]
  2. Eggers P. W., Prihoda R. Pre-enrollment reimbursement patterns of Medicare beneficiaries enrolled in "at-risk" HMOs. Health Care Financ Rev. 1982 Sep;4(1):55–73. [PMC free article] [PubMed] [Google Scholar]
  3. Eggers P. Risk differential between Medicare beneficiaries enrolled and not enrolled in an HMO. Health Care Financ Rev. 1980 Winter;1(3):91–99. [PMC free article] [PubMed] [Google Scholar]
  4. Ferraro K. F. Self-ratings of health among the old and the old-old. J Health Soc Behav. 1980 Dec;21(4):377–383. [PubMed] [Google Scholar]
  5. Fillenbaum G. G. Social context and self-assessments of health among the elderly. J Health Soc Behav. 1979 Mar;20(1):45–51. [PubMed] [Google Scholar]
  6. Fries J. F. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980 Jul 17;303(3):130–135. doi: 10.1056/NEJM198007173030304. [DOI] [PubMed] [Google Scholar]
  7. Greenlick M. R., Lamb S. J., Carpenter T. M., Jr, Fischer T. S., Marks S. D., Cooper W. J. Kaiser-Permanente's Medicare Plus Project: a successful Medicare prospective payment demonstration. Health Care Financ Rev. 1983 Summer;4(4):85–97. [PMC free article] [PubMed] [Google Scholar]
  8. Gruenberg E. M. The failures of success. Milbank Mem Fund Q Health Soc. 1977 Winter;55(1):3–24. [PubMed] [Google Scholar]
  9. Halpert B. P., Zimmerman M. K. The health status of the 'old-old': a reconsideration. Soc Sci Med. 1986;22(9):893–899. doi: 10.1016/0277-9536(86)90162-0. [DOI] [PubMed] [Google Scholar]
  10. Levkoff S. E., Cleary P. D., Wetle T., Besdine R. W. Illness behavior in the aged. Implications for clinicians. J Am Geriatr Soc. 1988 Jul;36(7):622–629. doi: 10.1111/j.1532-5415.1988.tb06158.x. [DOI] [PubMed] [Google Scholar]
  11. Linn B. S., Linn M. W., Knopka F. The very old patient in ambulatory care. Med Care. 1978 Jul;16(7):604–610. doi: 10.1097/00005650-197807000-00007. [DOI] [PubMed] [Google Scholar]
  12. Linn M. W., Linn B. S., Gurel L. Patterns of illness in persons who lived to extreme old age. Geriatrics. 1972 Jun;27(6):67–70. [PubMed] [Google Scholar]
  13. Longino C. F., Jr Who are the oldest Americans? Gerontologist. 1988 Aug;28(4):515–523. doi: 10.1093/geront/28.4.515. [DOI] [PubMed] [Google Scholar]
  14. Lubitz J., Prihoda R. The use and costs of Medicare services in the last 2 years of life. Health Care Financ Rev. 1984 Spring;5(3):117–131. [PMC free article] [PubMed] [Google Scholar]
  15. Manton K. G. Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q Health Soc. 1982 Spring;60(2):183–244. [PubMed] [Google Scholar]
  16. Manton K. G., Soldo B. J. Dynamics of health changes in the oldest old: new perspectives and evidence. Milbank Mem Fund Q Health Soc. 1985 Spring;63(2):206–285. [PubMed] [Google Scholar]
  17. Minaker K. L., Rowe J. Health and disease among the oldest old: a clinical perspective. Milbank Mem Fund Q Health Soc. 1985 Spring;63(2):324–349. [PubMed] [Google Scholar]
  18. Roos N. P., Shapiro E., Roos L. L., Jr Aging and the demand for health services: which aged and whose demand? Gerontologist. 1984 Feb;24(1):31–36. doi: 10.1093/geront/24.1.31. [DOI] [PubMed] [Google Scholar]
  19. Rosner T. T., Namazi K. H., Wykle M. L. Physician use among the old-old. Factors affecting variability. Med Care. 1988 Oct;26(10):982–991. doi: 10.1097/00005650-198810000-00006. [DOI] [PubMed] [Google Scholar]
  20. Schneider E. L., Brody J. A. Aging, natural death, and the compression of morbidity: another view. N Engl J Med. 1983 Oct 6;309(14):854–856. doi: 10.1056/NEJM198310063091411. [DOI] [PubMed] [Google Scholar]
  21. Soldo B. J., Manton K. G. Health status and service needs of the oldest old: current patterns and future trends. Milbank Mem Fund Q Health Soc. 1985 Spring;63(2):286–319. [PubMed] [Google Scholar]
  22. Streib G. F. The frail elderly: research dilemmas and research opportunities. Gerontologist. 1983 Feb;23(1):40–44. doi: 10.1093/geront/23.1.40. [DOI] [PubMed] [Google Scholar]
  23. Verbrugge L. M. Sex differentials in health. Public Health Rep. 1982 Sep-Oct;97(5):417–437. [PMC free article] [PubMed] [Google Scholar]
  24. Verbrugge L. M., Wingard D. L. Sex differentials in health and mortality. Women Health. 1987;12(2):103–145. doi: 10.1300/J013v12n02_07. [DOI] [PubMed] [Google Scholar]
  25. Wolinsky F. D., Mosely R. R., 2nd, Coe R. M. A cohort analysis of the use of health services by elderly Americans. J Health Soc Behav. 1986 Sep;27(3):209–219. [PubMed] [Google Scholar]

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