Disability among the elderly has declined

题型:单项选择题

问题:

Disability among the elderly has declined markedly in the United States in the past two decades. In 1984, 25 percent of the elderly population reported difficulty with activities associated with independent living. By 1999, the share had fallen to 20 percent, a decline of one-fifth. Although these basic facts are well known, their interpretation is not clear. Is the reduction in disability a result of improved medical care, individual behavioral changes, environmental modifications that allow the elderly to better function by themselves, or other demographic changes Will the trend continue, or is it time limited What does the reduction in disability mean for years of healthy life and labor force participation

The researchers David Cutler, Mary Beth Landrum, and Kate Stewart focus on disability caused by cardiovascular disease to investigate the role of improved medical care on reductions in disability. By looking at just one condition, they can analyze health shocks and their outcomes in some detail. Cardiovascular disease is a natural condition to analyze, because it is the most common cause of death in the United States and most other developed countries. Also, more is spent on cardiovascular disease than on any other condition, clearly a case where medical care could really matter.

The researchers measure disability as the presence of impairments in. Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Their data source, the National Long-Term Care Survey(NLTCS) , includes information on six ADL measures: eating, getting in or out of bed, walking around inside, dressing, bathing, and getting to or using the toilet. There are also questions about eight IADL measures: doing light housework or laundry, preparing meals, shopping for groceries, getting around outside, managing money, taking medications, and making telephone calls. The NLTCS is a nationally representative longitudinal survey of the health and disability profile of the population aged 65 and over.

Cutler and his co-researchers find that reduced disability associated with cardiovascular disease accounts for a significant part of the total reduction in disability--between 14 and 22 percent. The evidence suggests that improvements in medical care, including both increased use of relevant procedures and pharmaceuticals, led to a significant part of this decline in disability. Regions with higher use experienced substantial reductions in mortality and disability.

While precise data on the implications of reduced disability are lacking, the possible impact of disability reductions is staggering. The researchers estimate that preventing disability after an acute cardiovascular event can add as much as 3.7 years of quality-adjusted life expectancy, or perhaps $ 316,000 of value. The cost of this outcome is significantly smaller. The initial treatment costs range from $ 8,610 to $ 16,332, depending on the procedure used. Further, recent cost analyses reported that annual Medicare spending was lower for the non-disabled than the disabled, which suggests that higher treatment costs may be offset by lower future spending among a more healthy population. By virtually any measure, therefore, the researchers conclude that medical technology after acute cardiovascular episodes is worth the cost.

According to the text, the researchers’purpose is()

A. to study disability caused by cardiovascular disease

B. to examine the effect of improved medical care on reductions in disability

C. to analyze cardiovascular disease and their outcomes

D. to study the cause of cardiovascular disease

考点:普通考研中医综合中医综合
题型:单项选择题

首先考虑的诊断为

A.萎缩性胃炎

B.慢性胰腺炎

C.胰腺癌

D.十二脂肠溃疡

E.胃癌

题型:单项选择题

急性胃穿孔应选用的检查方法是

A.立位腹部X线千片和透视

B.腹部B超

C.上消化道钡剂造影

D.腹部CT检查

E.腹部MRI检查

题型:单项选择题

男性,45岁。咳嗽、低热,痰中带血2个月。有肺结核病史。X线胸片检查:左肺上叶不张。

目前,首先要做的检查是()

A.痰找抗酸杆菌,痰找瘤细胞

B.胸部CT检查,经胸壁穿刺检查

C.胸部CT检查,支气管镜检查

D.支气管镜检查,纵隔镜检查

E.痰找瘤细胞,放射性核素扫描

题型:单项选择题

组织传播

题型:单项选择题

教学关系是静态的、固定的。

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