Ray W A, Federspiel C F, Baugh D K, Dodds S
Am J Public Health. 1987 Jun;77(6):699-703. doi: 10.2105/ajph.77.6.699.
We utilized Medicaid data from five states which account for 39 per cent of Medicaid expenditures to study the impact of the near-trebling of persons age 85 and older (the very old) projected to occur by the year 2012 upon Medicaid nursing home expenditures. We found a one-year prevalence of Medicaid-covered nursing home residence of 20 per 100 among the very old. If this rate continues, with no changes in current levels of Medicaid nursing home payments, and if population forecasts are accurate, increasing numbers of the very old will generate an additional +6.3 billion (1982 dollars) annually of Medicaid nursing home payments by 2012: an increase of 280 per cent from 1982 levels. The stress this trend will place upon societal ability to check growth in public expenditures for medical care while maintaining basic services for other low income populations will be an important force shaping public health policy in the next 25 years.
我们利用了来自五个州的医疗补助数据（这五个州的医疗补助支出占总额的39%），以研究预计到2012年85岁及以上老年人（高龄老人）数量近乎增至三倍对医疗补助养老院支出的影响。我们发现，高龄老人中医疗补助覆盖的养老院入住率为每100人中有20人。如果这一比率持续不变，且医疗补助养老院支付的当前水平不变，同时人口预测准确无误，那么到2012年，越来越多的高龄老人将使医疗补助养老院支付额每年额外增加63亿美元（按1982年美元计算）：相较于1982年的水平增长280%。这一趋势给社会在控制医疗公共支出增长同时为其他低收入人群维持基本服务的能力所带来的压力，将成为未来25年塑造公共卫生政策的一股重要力量。
