関連する実験動画
複数の慢性疾患を患っている高齢者のための総合的なプライマリケア: "誰も急ぎません"
1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. cboult@jhsph.edu
JAMA
|November 4, 2010
まとめ
複数の慢性疾患を患っている高齢者のための効果的なプライマリケアには,積極的なプロセスが必要です. これには包括的な評価,エビデンスベースの計画,患者の関与,ケアコーディネーション,分散したケアを改善するなどが含まれます.
科学分野:
- ゲリアトリクス ゲリアトリクス
- プライマリーケア (プライマリーケア)
- 医療サービス 研究 医療サービス
背景:
- 複数の慢性疾患を患っている高齢者は,しばしば断片化され,効果のない医療を体験します.
- 伝統的な疾患特有の管理は,複雑な高齢者のケアニーズに対応するのに不十分です.
研究 の 目的:
- 多重の慢性疾患を持つコミュニティに住む高齢者のプライマリケアを改善するための積極的なプロセスを特定する.
- 効果と効率を高める慢性介護のモデルを記述する.
主な方法:
- 入手可能な証拠に関する専門家のコンセンサス.
- 複雑な高齢患者のケースイラスト.
- 4つの主要なケアプロセスの説明.
- 3つの慢性ケアモデル (GRACE,ガイドケア,PACE) の概要
主要な成果:
- 4つの積極的なプロセスは,プライマリケアを改善することができます:包括的な評価,エビデンスベースの計画/モニタリング,患者/介護者の関与,および専門的なケア調整.
- これらのプロセスは,患者の目標と好みに合わせて調整されるべきです.
- 3つのモデル (GRACE,ガイドケア,PACE) は,これらのプロセスを組み込み,効果と効率の向上の可能性を示しています.
結論:
- 複数の慢性疾患を患っている高齢者の管理には,積極的,継続的,協調的なアプローチが不可欠です.
- GRACE,ガイドケア,またはPACEのようなモデルを実装することで,複雑なプライマリケアの質と効率を高めることができます.
- 患者の個別の目標と好みに合わせてケアを行うことは,治療の成功に不可欠です.
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