Aging and Health
Overall life expectancy in the United States increased dramatically throughout the 20th century, and the number of older Americans will be at its highest in the coming decades. Older patients are a particularly important focus for quality-of-care evaluation because they are at risk of serious declines in health and function as a result of poor care and because they use a large amount of health care resources. Challenges for health policy include caring for elders in nursing homes and in the community, assessing the quality of that care, designing and monitoring payment systems for that care, and building interdisciplinary academic capacity in geriatrics. Our current research efforts in these areas are highlighted below.
Profiles of Current Research
Highlights of Recent Studies
Life Expectancy Is Better Than Age as a General Predictor of Health Care Expenditures
Medicare Expenditure estimates based on life expectancy match actual expenditures more closely than do age-based estimates. But neither age nor life expectancy has strong predictive power if health status is included in the model.Modeling the Health and Medical Care Spending of the Future Elderly
Medical innovations will improve health and extend life but will likely increase Medicare spending; eliminating obesity and better prevention will likely save Medicare money and improve health.Improving the Quality of Health Care for Older Adults
The Assessing Care of Vulnerable Elders (ACOVE) indicators were the first set of health quality indicators developed specifically for the elderly. In 2007, the ACOVE indicators were updated to include more health conditions and to give greater consideration to the appropriateness of care for patients with advanced dementia or an otherwise poor prognosis.A Look Inside the "Doughnut Hole": How Drug-Benefit Limits Affect Retiree Prescription Use
High-cost enrollees in a retiree plan that capped yearly drug benefits at $2,500 discontinued medication at higher rates than comparable patients in an uncapped plan.
Related Web Sites
RAND Southern California Evidence-Based Practice Center
RAND Center for Population Health and Health Disparities
RAND Roybal Center for Health Policy Simulation
ACOVE (Assessing Care of Vulnerable Elders)
UCLA Older Americans Independence Center (Pepper Center)
Building Interdisciplinary Geriatric Health Care Research Centers
Working with Congress
RAND’s Office of Congressional Relations (OCR) furthers RAND’s mission to provide objective analysis and effective solutions by disseminating research results to Congress and federal agencies. OCR publishes a monthly electronic newsletter featuring current work on health policy. The RAND Health Congressional Newsletter is found at www.rand.org/congress/newsletters.html. Contact: Shirley Ruhe (Shirley_Ruhe@rand.org).


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