STAROSNA STRUKTURA STANOVNIŠTVA I ZDRAVSTVENI SISTEM SRBIJE

1. STAROSNA STRUKTURA STANOVNIŠTVA I ZDRAVSTVENI SISTEM SRBIJE PRIM DR SCI MED TATJANA RADOSAVLJEVIĆ, LEKARSKA KOMORA SRBIJE

2. OČEKIVANO TRAJANJE ŽIVOTA I TROŠKOVI ZDRAVSTVENE ZAŠTITE Source: World Development Indicators, 2007

3. UVOD STAROST NIJE BOLEST,PREDSTAVLJA TREĆE ŽIVOTNO DOBA Starenje je proces koji podrazumeva skup bioloških,socijalnih i psiholoških promena,i rezultat je progresivnih degenerativnih promena Starije osobe pate od komorbiditeta. .

4. ISTRAŽIVANJA ZDRAVSTVENIH POTREBA STARIH PREKO 75% STARIH IMA TRI ILI VIŠE OBOLJENJA OBOLJENJA SU HRONIČNOG KARAKTERA KONTINIURANO LEČENJE SPREČAVANJE NASTANKA KOMPLIKACIJA SPECIFIČNA ZDRAVSTVENA NEGA .

5. Data from CMS -2007

6. MESEČNI TROŠKOVI:starost70-74 • zdravi: $410-446 • dijabetičaric: $701-750 • CHF: $750-950 • Srčani udar: $751-1,000

7. Medicare Eligibility • Age 65 or over- 39.6 million in 2010 • Or on Social Security Disability for over 24 months- 7.9 million in 2010 • Or receiving dialysis treatment • Patient or Spouse paid Social Security Taxes • 10,000 persons/day turning 65 in U.S.

8. Covered Medicare Preventive Services • Lipid Panel screen every 5 years • Colon Cancer Screening every 2-10 years • Annual Mammograms • PSA and DRE • Bone Density Testing every 2 years • Glaucoma Screening every 1 year • Diabetes screening twice a year • Smoking cessation counseling • Vaccination: Hepatitis B, Influenza, Pneumococcal, Td post injury • PAP every 2 years • Welcome to Medicare Exam (within first 6 months) then q 12 mo (since 2011) • AAA screening once (in former smokers) • Depression screening annually • HIV screening annually

9. Noncovered Medicare Services • Outpatient Prescription Drugs • Unless the patient elected Part D coverage • Hearing and Vision Services • Dental Care • Hospital Care over 210 days • Nursing Home Care • Maintenance Home Care • Not: EKGs, PFTs, CXRs if “screening/baseline”

10. Medicine Costs • Self Pay • Insurance with Co-Pays • State Programs • Medicare Part D benefit • Indigent Drug Programs from Pharmaceutical Companies • Generic vs. Brand Name • Newer Drugs vs. Older Drugs

11. Nursing Home Costs • 50% of all persons 65 and older will use a Nursing Home • 46% of stays are for less than 12 months • 21% stay more than 4 years accounting for 2/3rds of days and costs • Women have a threefold higher lifetime risk of admission (they live longer and are more often alone)

12. Elderly Finances • Income from • Social Security • Pension • Savings • Bank Accounts • Investments • Current Employment • Reverse Mortgage

13. Who has Money?

14. SISTEM ZDRAVSTVENE ZAŠTITE STARIH U NEMAČKOJ • POPULACIJA STARIH JE JEDNA OD NAJVULNERABILNIH POPULACIJA U SISTEMU ZDRAVSTVENE ZAŠTITE • PODLOŽNI MNOGIM BOLESTIMA • OGRANIČENI PRISTUP ZDRAVSTVENOM OSIGURANJU • NEPOSTOJEĆI PRISTUP DUGOTRAJNIJOJ NEZI • SMANJENI KVALITET ŽIVOTA

15. ZADOVOLJSTVO ZDRAVSTVENOM NEGOM STARIH U NEMAČKOJ • 29%STARIH ZADOVOLJNO ZDRAVSTVENOM ZAŠTITOM • 54% IMA LOŠE ZDRAVLJE • 38% JE POSETILO LEKARA ŠEST I VIŠE PUTA • 6% JE PLATILO IZ DZEPA DODATNE TROŠKOVE • 15% VIDI SISTEM ZDRAVSTVENE ZAŠTITE KAO NEADEKVATAN

16. MOGUĆA REŠENJA • KAKO IZGRADITI ZDRAVSTVENI SISTEM KOJI STARIMA PRUŽA VISOKOKVALITETNU NEGU NA PRAVOM MESTU I U PRAVO VREME,ZAVISNO OD POTREBA? • -KUĆNA NEGA • -DNEVNA NEGA • -OBUČENE MEDICINSKE SESTRE • -BOLNICE

17. MOGUĆA REŠENJA • ELEKTRONSKI KARTON • TELEMEDICINA • STARAČKI DOMOVI • HOSPISI