Averting an Impending Storm Can We Reengineer Health Systems to Meet the Needs of Aging Populations 英文参考文献.docVIP
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Averting an Impending Storm Can We Reengineer Health Systems to Meet the Needs of Aging Populations 英文参考文献
Perspective
AvertinganImpendingStorm:CanWeReengineer
HealthSystemstoMeettheNeedsofAgingPopulations?
ArleneS.Bierman1,2
*
1KeenanResearchCentreintheLiKaShingKnowledgeInstitute,St.Michael’sHospital,Toronto,Ontario,Canada,2LawrenceS.BloombergFacultyofNursing;Institute
ofHealthPolicy,EvaluationandManagement;DepartmentofMedicine,UniversityofToronto,Toronto,Ontario,Canada
TheImpendingStorm:
AddressingtheHealthNeedsof
AgingPopulations
reportedelsewhere[5,6].At2years,there
wasnoimprovementinqualityoflife[5].
The overall intervention did not reduce
hospitalization rates and was not cost
saving. It was, however, cost saving for
highriskparticipants,amongwhomthere
was a 39% reduction in hospitalizations
and 37% reduction in emergency visits.
Resultsforqualityimprovementmeasures
were modest at best; there was improve-
ment on four of 12 quality indicators
assessingpreventiveservicesandonlyone
LinkedResearchArticle
This Perspective discusses the fol-
lowingnewstudypublishedinPLoS
Medicine:
The perfect storm is brewing. The
proportion of the world’s population age
60 and older is projected to grow from
11%to22%betweentheyears2000and
2050, an absolute increase from 605
million to 2 billion people [1]. Health
systemsacrosstheglobeareillpreparedto
meettheneedsofagingpopulations.The
challenges are many. Underinvestment in
preventioncontributestotherisingburden
of chronic illness. Quality of care for
chronic conditions is suboptimal; care for
geriatric conditions such as falls or de-
mentiaisevenworse[2].Mostolderadults
have multiple chronic conditions, but
quality improvement efforts commonly
focus on single diseases such as heart
failure or diabetes. Older adults oftensee
multiple providers in multiple settings of
care (e.g., ambulatory primary and spe-
cialty care, hospital care, home care) and
may have complex social needs. The
health care they receive tends to be
fragmented and poorly integrated with
community services. The workforce lacks
Coburn KD, Marcantonio S, La-
z
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