Nation faces future caregiver shortage

Chilling implications for an aging population

Case managers working with long-term care and elderly populations know the challenges of finding appropriate caregivers for their patients. Those challenges will reach crisis proportions early in the 21st century, according to a recent report in the Journal of the American Medical Association.

Researchers from the University of California San Francisco Institute of Health and Aging found that the current health care delivery system in the United States is so geared toward acute care, that it fails to meet the needs of the chronically ill, who numbered 100 million in 1995. Some of the reports more alarming findings include:

• By 2030, there will be only six potential caregivers, such as family members or friends, for every person 85 or older as compared to 21 potential caregivers for each person in 1970.

• By 2020, up to 14 million elderly will need long-term care. This is double the seven million who need long-term care today.

• By 2030, unless new systems of care are created, researchers predict that chronic care alone will cost $798 billion in 1990 dollars for direct medical and nursing home costs.

• Seven out of every 10 hospital admissions are for persons with chronic illnesses.

• Almost half the American population has chronic conditions which account for three-fourths of all health care expenditures in the United States.

The study was supported by a grant from the Robert Wood Johnson Foundation in Princeton, NJ. Study results are outlined in a 76-page chartbook, Chronic Care in America: A 21st Century Challenge. To request a free copy of the chartbook, contact: The Robert Wood Johnson Foundation, P.O. Box 2316, Princeton, NJ 08543-2316. E-mail:

[See: Hoffman C, Rice D, H-Y Sung, et al. Persons with chronic conditions: Their prevalence and costs. JAMA, 1996; 276 (18):1,473-1,479.]