Challenges of systems of care for frail older persons: the United States of America experience.

The concomitant demographic and economic imperatives of an increasingly aged and frail population in the United States provide a compelling rationale for the development of systems of care that provide greater integration and improved quality of care. After providing the supporting statistics that illuminate the challenges faced by this country, this article then examines the current organization and financing of services pertinent to the care of frail older adults. These individual services, however, comprise a continuum of care more by default than by design. Greater integration is needed to meet the needs of this population that requires care from different providers in multiple settings. Fortunately, innovations are being implemented that integrate acute care with chronic and long-term care, providing reason for hope that the health care system in the United States is responding to these imperatives.