Averting an Impending Storm Can We Reengineer Health Systems to Meet the Needs of Aging Populations 英文参考文献.docVIP

Averting an Impending Storm Can We Reengineer Health Systems to Meet the Needs of Aging Populations 英文参考文献.doc

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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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