In 1965, the US Congress passed the Social Security Amendment which established Medicare, which provides for a basic program of hospital insurance together with a medical insurance program. This national health insurance progr4am is intended for citizens aged 65 and over and also for citizens with some form of disabilities under age 65. Today, the Centers for Medicare and Medicaid Services is appointed with the task of administering Medicare (Pulec 2003, p.7-8).The federal government of USA shoulders the funding for this health care program which it generates from social security contributions, general government revenues, and monthly premiums paid by enrolled members (Pratt Hornbeck, 2002).In African countries, particularly South Africa, they have expressed a “need for an effective but simple nutrition screening tool that can be used by all levels of health care workers, particularly at community clinics” (Charlton et al 2005). This need is echoed in practically all the four corners of the world: in USA, Europe, Latin America, and Asia.Malnutrition is defined as a “condition resulting from a decreased intake of protein and energy, calories, vitamins, and minerals” (Stechmiller 2003, p.170). Malnutrition is also a condition with an imbalance between intake and the needs of specific nutrients (Elmstahl et al 1997, p.854). The same author thus considers as malnourished or suffering from undernutrition, those older citizens who do not consume the recommended 30 kcal/kg/day for energy needs. As such, this elderly citizen is considered “in a high risk for nutrient deficiency” (Stechmiller 2003, P. 171). He is then subject to a possible or a likely attack of “cardiac and respiratory problems, infections, deep vein thrombosis, and pressure ulcers, perioperative mortality and multi-organ failure” (Omran Morley 2000, p.50-63).These malnourished citizens would naturally then be pressured to undergo rehabilitation at hospitals, in accordance with the Medicare program and are expected to suffer complications.
Assessment Methods of Nutritional Status