Changes in the demographics and healthcare needs of the U.S. population have forced a shift in the types of healthcare services that people want and need. Hospitals are faced with the challenge of meeting the needs of an increasingly older and frailer population. An American born in 2000 can expect to live to nearly 77 years old; a 65 years old can expect to live another 18 years (Federal interagency forum on aging-related statistics, 2002). In addition, technological advancements have allowed individuals to live longer with chronic, advanced illness. For example, the elderly often experience chronic, progressive diseases that they will live with for three to six years before death (Fried, 2000). These changes have placed pressures on the healthcare system to design practices and programs that best meet the needs of the population. Table 1.1. highlights some of the demographic and care needs that hospitals must address.
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