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Healthcare is ‘extremely complex’ for older people, experts say: ‘an ever-increasing barrier’

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Adults tend to need more medical care as they age, but coordinating that care can be stressful and arduous for older adults.

Obtaining in-person care and treatment can require “a lot of time, effort and money” to the elderly and their partners or caregivers, according to a new study from Brigham and Women’s Hospital in Boston.

Led by Ishani Ganguli, associate professor of medicine at Harvard Medical School, researchers examined data from 6,619 adults ages 65 and older, who responded to data from the 2019 Current Medicare Beneficiaries Survey, to get an idea of ​​the number of days spent receiving medical care. care.

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During that year, older adults had an average of 17.3 “ambulatory contact days,” which consisted of visits to an primary care physician or specialist doctor – or a test, imaging procedure or treatment.

They had an average of 20.7 total contact days, which also included days spent in a hospital, emergency department, skilled nursing facility or hospice facility.

A man angry with the doctor

Adults tend to need more medical care as they age, but coordinating that care can be stressful and arduous for older adults. (iStock)

About 11% of adults had 50 total contact days or more.

“Some of these measures may be very beneficial and valuable to people, and others may be less essential,” Harvard Medical School’s Ganguli told KFF Health News.

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“We don’t talk enough about what we’re asking older people to do and whether it’s realistic.”

Across all these medical touchpoints are different guidelines regarding medical conditions, financial incentives offered to doctors and the need for specialized care, Ganguli noted.

“It is not uncommon for older patients to have three or more heart specialists who schedule regular appointments and tests,” she also said.

Injured woman on the phone

For patients with multiple health conditions, it can be difficult to juggle multiple appointments with different providers over multiple days each month. (iStock)

For patients with multiple health conditions, there are even more appointments to juggle.

“The good news is that we know a lot more and we can do a lot more for people with a variety of conditions,” Thomas H. Lee, chief medical officer of Press Ganey, a consulting firm that tracks patient experiences of health care. Health information.

“The bad news is that the system has become extremely complex.”

“Laden with complexity”

Dr. Marc Siegel, clinical professor of medicine at Langone Medical Center of New York and Fox News medical contributor, was not involved in the research but acknowledged that medical complexity for older people is a “huge problem” in the United States.

“The medical system is overburdened because of the pandemic, and there is a shortage of doctors and nurses,” he told Fox News Digital.

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At the same time, the health care needs of the nation’s older adults are growing, thanks in part to technological advances to manage chronic illnesses, Siegel noted.

“At the same time, the scope of Medicare coverage is shrinking, as well as the scope of providers who can work with it,” the doctor added.

“And the barriers to obtaining necessary procedures and treatments are increasing, as are out-of-pocket costs.”

Man with medical bill

Obtaining in-person care and treatment can require “significant time, effort and money” for older adults and their partners or caregivers, according to a new study. (iStock)

Dr. Shana Johnson, Physical Medicine and Rehabilitation Physician in Scottsdale, Arizonasaid the complexity of navigating the U.S. healthcare system poses an “ever-increasing barrier” to obtaining medical care.

“Every step in the healthcare system is fraught with complexity – from making an appointment with a provider who accepts your insurance, to filling a prescription you can afford, to determining which tests medical services that you actually need,” she told Fox News Digital.

Johnson was not involved in the new study.

“Barriers to obtaining necessary procedures and treatments are increasing, as are out-of-pocket costs.”

In her new role as an independent health system consultant, Johnson strives to help patients navigate this complexity.

“A growing number of people are seeking help navigating the system and finding appropriate care,” she said.

doctor and patient

“Every step in the healthcare system is fraught with complexity – from making an appointment with a provider who accepts your insurance, to filling a prescription you can afford, to determining which tests medical services that you really need.” (iStock)

A patient recently contacted Johnson for help after her primary care doctor’s failed attempts to refer her to a rheumatologist.

“First her doctor sent her to University Medical Center,” she said. “They refused the referral because their appointment slots were reserved for very complex cases and his case was not considered difficult enough.”

A second referral was made to a private rheumatology practice, but they declined because they did not accept Medicaid Insurance.

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“Fewer private practices accept Medicaid because of low reimbursement rates,” Johnson noted.

At this point, the patient contacted Johnson for help connecting to care.

“After speaking with her, I suspected she had fibromyalgia, which increased the number of specialists who could help her,” she said.

Telehealth for senior couples

The rise of digital technologies in the health care system can add another layer of challenges for older adults, experts agree. (iStock)

Johnson referred the patient to a pain clinic in a large hospital system – but the clinic refused the referral because it was too busy with opioid patients and could not accept outside references.

Additionally, the patient’s doctor did not work for the hospital system.

“Then I tried the General Physical Medicine and Rehabilitation clinic,” Johnson said. “They said no because she was a better fit for the pain clinic who refused to see her.”

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At this point, the patient had waited five months, in pain, trying to get a diagnosis – and treatment had not even started.

Johnson noted, “This patient’s difficulties are not unique – they are usual. »

Risks of neglected care

Faced with the “treatment burden” of making appointments, finding transportation, following up with insurance companies, integrating doctors’ recommendations and managing medical costs, many Older people can choose to forgo care altogether, according to Victor Montori, a professor of medicine. at the Mayo Clinic in Rochester, Minnesota.

Older people who suffer from multiple health problems and those with “low education” are most at risk.

In a 2020 research paper, Montori found that about 40% of patients with chronic conditions “considered their treatment burden (to be) unsustainable.”

Those most at risk are older adults who suffer from multiple health conditions and those who have “low education” or are “economically precarious and socially isolated,” as KFF reports.

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The increase in digital technologies in the health care system can add another layer of difficulties for older people, experts agree.

“It’s increasingly difficult for patients to have access to clinicians who can solve their problems and answer their questions,” Montori told KFF.

Tips to reduce the burden

Elizabeth Rogers, assistant professor of internal medicine at the University of Minnesota Medical School, shared with KFF Health News her tips for making care more accessible to older adults.

First, she recommends giving feedback to doctors if a treatment plan doesn’t seem sustainable.

Social worker with senior

Some medical centers may have social workers or “patient navigators” on staff to help seniors coordinate and consolidate appointments. (iStock)

“Be sure to discuss your health priorities and trade-offs: what you might gain and what you might lose by forgoing certain tests or treatments,” she told KFF.

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It’s also important to discuss which medical interactions are essential and which can be skipped, Rogers said.

Based on these discussions, doctors may be able to make adjustments treatment plans or prescriptions.

Seniors should ask questions to make sure they understand their doctor’s instructions.

Some medical centers may have social workers or “patient navigators” on staff to help seniors coordinate and consolidate appointments and arrange transportation if necessary.

Rogers also stressed the need for seniors to ask questions to ensure they understand their doctor’s instructions.

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“I would ask a clinician, ‘If I choose this treatment option, what does that mean not only for my cancer or heart disease, but also for the time I will spend receiving care?'” Harvard’s Ganguli told KFF.

“If they don’t have an answer, ask if they can give you an estimate.”

For more health articles, visit www.foxnews.com/health.

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