Revista de síndrome metabólico

Suboptimal care of hospitalized older patients in the United States; itâ??s never too late to improve the quality of care

Abstract

Kranthi Sitammagari

The average life expectancy of individuals in the United States (US) has increased dramatically in the last century due to public health strategies and advances in medical treatment. It is expected that more than 20% of US population will be over 65 years of age by 2030. Older patients suffer from significant chronic medical problems including heart disease, cancer, stroke, dementia, and diabetes etc. requiring frequent hospitalizations. Almost half of the adults who get hospitalized are ≥ 65 yrs. and this proportion increases as the population ages. Hospital care costs Medicare about $149 billion per year in 2015, representing 25% of health care expenditures in the US. Hospitalization causes functional decline and increases mortality and morbidity due to confinement, immobility, diagnostic testing, and treatment especially changes in drug regimen, complications including delirium, falls, infections and death. Acute hospital care should only last long enough to allow successful transition to home care, a skilled nursing facility, or an outpatient rehabilitation program