行为健康整合在全包老年护理计划 (PACE) 的框架
Alexa Fleet1,2, Alya Simoun1, Daniel Shalev3
1New York State Psychiatric Institute, New York, New York, USA.
Journal of the American Geriatrics Society
|January 17, 2025
概括
在老年人全方位护理计划 (PACE) 中,行为健康整合 (BHI) 对老年人至关重要. 这项研究开发了一种BHI-PACE模型,发现行为健康并发症的高率,突出了改善整合的必要性.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 心理健康服务 心理健康服务
背景情况:
- 全方位老年护理计划 (PACE) 服务于有资格接受养老院护理的老年人,促进社区老龄化.
- PACE计划为双重医疗保险和医疗补助受益人提供全面的医疗保健.
- 老年人面临着进入行为健康 (BH) 服务的障碍,需要在PACE中更好地整合.
研究的目的:
- 调查PACE组织 (PO) 内的行为健康整合 (BHI).
- 在PACE中开发BHI的概念框架.
- 报告PO的当前BH实践和需求.
主要方法:
- 调整了BH-严重疾病护理 (BH-SIC) 模型,以创建BHI-PACE模型.
- 使用混合方法的顺序方法:调查,用例采访和定性分析.
- 通过调查对38个生产企业 (119个地点) 和采访对15个生产企业 (58个地点) 进行了BHI评估.
主要成果:
- 开发了具有定义域和子域的BHI-PACE模型.
- 在PACE参与者 (60%中位数) 中确定了高BH并发症率.
- 常见的转诊原因包括抑郁症 (92.1%),痴呆症的行为和心理症状 (57.9%) 和焦虑 (55.3%).
结论:
- 目前的PO BH实践和挑战为其他PO提供了指导.
- 将BH纳入PACE需要在政策层面采取行动.
- 质量测量和基于价值的护理可以支持BH在PACE的整合.
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