Chronic disease causes considerable functional impairment in the U.S. elderly population. Recent changes in mortality at late ages will interact with changes in chronic disease behavior to determine its effects on the U.S. elderly and oldest-old population and upon measures of life expectancy and active life expectancy in that population. To study how mortality, disability, and morbidity relations have changed in the U.S. elderly population, the investigators propose linking data on chronic diseases with a large population impact, like hip fracture and stroke, from the 1982, 1984, 1989, and 1994 National Long Term Care Surveys (NLTCS) to more detailed data on the disease in Medicare files and from a sample of medical charts. The gathering of the more detailed information will involve a follow-up survey of persons drawn from the NLTCS list sample in order to get permission for medical record abstractions. With that medical record data, the investigators can better assess the parameters of the disease's behavior in the population and how various types of intervention may affect its population frequency and duration in the elderly (65+) and oldest-old (85+) populations. Once the data have been collected, analyses will be made using appropriate multivariate procedures to assess the physical status of persons with a specific disease. The procedure will generate health and functional scores that will be used to a.) make cost estimates of the diseased of the U.S. elderly, Medicare eligible population (specific to type of service), b.) evaluate the cost effectiveness of several types of interventions in controlling or managing the disease, c.) project future costs of illness for the specific disease, and d.) simulate the implications of the significant intervention efforts identified in the cost effectiveness studies.
