老年医疗卫生服务模式研究
Research on Geriatric Healthcare Service Model
DOI: 10.12677/ar.2014.11004, PDF, HTML,  被引量 下载: 3,307  浏览: 12,824  科研立项经费支持
作者: 宋岳涛, 陈 峥, 王进堂:北京老年医院——北京市中西医结合老年病学研究所,北京
关键词: 医疗卫生服务老年医学中期照护长期照护临终关怀Healthcare Service; Geriatrics; Intermediate Care; Long-Term Care; Hospice
摘要: 目的:探讨如何构建我国的老年医疗卫生服务模式,以便更好地节约医疗资源、降低医疗费用和为老年人谋福祉。方法:通过文献调研、专家访谈和国内外参观考察等方式,调查了解国内外老年医疗卫生服务的现状,并结合我国的实际,提出构建我国老年医疗卫生服务模式的基本构架。结果:通过调研发现,我国现有的老年医疗卫生服务是以疾病为中心和以急性期的医疗服务为重点,缺乏必要的老年病急性前期和急性后期的医疗卫生服务,呈现出一种“纺锤型”的服务模式,造成极大的医疗资源浪费和医疗费用节节攀升的局面,不能合理有效地满足老年人的医疗卫生服务需求。结论:我国应构建“分层管理、无缝衔接和医养结合”的老年医疗卫生服务模式,既需加强老年病急性前期的健康促进、预防保健和慢病防控,也需加强老年病急性后期的中期照护、长期照护和临终关怀,尽可能构建一种“哑铃型”的老年医疗卫生服务模式。
Abstract: Objective: To explore how to build a geriatric healthcare service model in China in order to save medical resources, to reduce healthcare costs and to provide better well-being for the elderly. Methods: The exploratory methods, including the literature search, interviews with experts, and domestic and foreign hospital visits, etc., are utilized to investigate the status of domestic and foreign geriatric healthcare services, and the basic framework of national geriatric healthcare service model is put forward and established. Results: It’s found during investigation that the existing medical healthcare service model of our country is based on the disease itself, and mainly focuses on aged acute care. Therefore, it lacks the necessary pre-acute and post-acute care, which shows a “spindle-type” service model and causes great waste of medical resources and rising healthcare costs, and cannot effectively meet the needs of the elderly medical healthcare services. Conclusion: The geriatric healthcare services of our country should be established featuring layered management, seamless connection and the combination of medical treatment and life support. Not only the pre-acute geriatric health promotion, preventive care and chronic disease prevention and control need to be strengthened, but also the post-acute intermediate care, long-term care and hospice need to be strengthened, in order to construct a "dumbbell-type" geriatric healthcare service model.
文章引用:宋岳涛, 陈峥, 王进堂. 老年医疗卫生服务模式研究[J]. 老龄化研究, 2014, 1(1): 23-28. http://dx.doi.org/10.12677/ar.2014.11004

参考文献

[1] 陈峥, 宋岳涛 (2009) 北京市老年医疗服务体系建设构想. 中华健康管理学杂志, 4, 248-250.
[2] 陈峥, 宋岳涛, 王进堂 (2012) 北京老年医疗连续性服务的构建策略及其应用. 中华老年医学杂志, 7, 545-548.
[3] Leng Sean, X. (2012) 打破传统亚专科片段医疗服务模式引进现代老年医学观念. 中华老年医学杂志, 1, 7-9.
[4] Oo, M.T. and D’Costa, D. (2012) Interface geriatrics: Modernising conventional geriatric medical care. Clinical Medicine (London, England), 12, 99-100.
[5] Sieber, C., Penz, M., Gerber, H., et al. (2008) Quality assurance in geria-trics—Opportunities and risks involved in the current health care reform in Germany. Die Rehabilitation, 47, 180-183.
[6] Leff, B., Spragens, L.H., Morano, B., et al. (2012) Rapid reengineering of acute medical care for Med-icare beneficiaries: The Medicare innovations collaborative. Health Affairs (Millwood), 31, 1204-1215.
[7] Fox, M.T., Sidani, S., Persaud, M., et al. (2013) Acute care for elders components of acute geriatric unit care: Systematic descriptive review. Journal of the American Geriatrics Society, 61, 939-946.
[8] Arbaje, A.I., Maron, D.D., Yu, Q., et al. (2010) The geriatric floating interdisciplinary transition team. Journal of the American Geriatrics Society, 58, 364-370.
[9] Di Sabatino, S. (2009) Geriatric emergency management in Ontario: A model for senior’s care. Perspectives, 33, 1822.
[10] Prez-Zepeda, M.U., Gutirez-Robledo, L.M., et al. (2012) Comparison of a geriatric unit with a general ward in Mexican elders. Archives of Gerontology and Geriatrics, 54, 370-375.
[11] Brusco, N.K., Taylor, N.F., Watts, J.J., et al. (2014) Economic evaluation of adult rehabilitation: A systematic review and meta-analysis of randomized controlled trials in a variety of settings. Archives of Physical Medicine and Rehabilitation, 95, 94-116.
[12] Peter, W., New Peter, A., Cameron John, H., et al. (2011) Inpatient subacute care in Australia: perceptions of admission and discharge barriers. The Medical Journal of Australia, 195, 538-541.
[13] 徐春红, 许慧丽 (2008) 澳大利亚老年保健服务体系对我国的借鉴意义. 中国医院管理, 8, 56.
[14] 宋岳涛, 陈峥, 白旭晶 (2013) 老年中期照护研究进展. 实用老年医学, 2, 162-164.
[15] 陈峥 (2013) 老年医疗连续性服务模式构想. 中国医院院长, 5, 91.
[16] 庞国明 (2007) 加快构建老年医疗服务体系. 中国医药指南, 7, 18-19.
[17] 王海波 (2010) 新型医疗服务模式下电子病历管理的研究. 山东师范大学, 济南.
[18] Mark, R.S., Lamba, S., et al. (2013) Palliative medicine and geriatric emergency care: Challenges, opportunities, and basic principles. Clinics in Geriatric Medicine, 29, 1-29.
[19] 谢海雁, Sean Leng, 李冬晶, 等(2010) PACE-新型而高效的老年人医疗服务模式. 国际老年医学杂志, 3, 135138.
[20] 程先峰 (2009) 老年病人的医学问题及应对措施. 中国医疗前沿, 18, 17, 53.