The Changing Face of General Internal Medicine and Lessons Learned from Geriatric Medicine

Abstract

This issue of JGIM contains a collection of articles focused on geriatrics that is being published at a significant juncture in United States healthcare, perhaps not seen since the introduction of Medicare in the 1960s. As the need to address the complex intersection of an aging, sicker population is compounded by potential limitations of staffing, healthcare delivery, reimbursement, and policies, these articles help frame the discussion of the future role of general internal medicine. Older adults (people 65 and older) currently comprise 13 % of the US population and account for 43% of annual inpatient care spending. That portion of the population is expected to continue using more health care services, and to increase from 13 % to 19 % of the population by 2030.1 Older adults are at greater post-hospitalization risk; one in 20 die during hospitalization and another 20–30 % die within one year following hospital discharge.2 Since this population has the highest prevalence of chronic illness and highest per capita health care spending, effective and efficient care of older adults is critical to controlling future federal spending. Areas addressed by the authors of these articles include: further evaluating the training of primary care providers; re-evaluating methods for health care delivery; and continuing down the path of new funding and research mechanisms in geriatrics. Additional commentary regarding these topics is provided below.