Kodner D L
Health Prog. 1989 Dec;70(10):54-7, 72.
In the next two decades, rapid, fundamental changes will take place in the way we finance, organize, and provide long-term care services. Because the elderly make up such a large portion of the patient population, America's hospitals should be concerned--and involved. There are six keys to the future of long-term care: a sharp increase in elderly population, a new generation of elderly, restrained government role, intergenerational strains, growing corporate concern, and the rise of "gerotechnology." These trends and countertrends will result in a new look in the long-term care landscape. By the year 2010, changes will include a true public-private financing system, provider reimbursement on the basis of capitation and prospective payment, coordinated access to services, dominant alternative delivery systems, a different breed of nursing homes, fewer staffing problems, patient-centered care, a new importance in housing, and an emphasis on prevention. For hospitals, this future vision of long-term care means that significant opportunities will open up to meet the needs of the elderly-at-risk and to achieve a competitive position in the burgeoning elderly care industry.
在未来二十年里，我们为长期护理服务提供资金、组织和服务的方式将发生迅速而根本性的变化。由于老年人在患者群体中占比很大，美国的医院应该予以关注并参与其中。长期护理的未来有六个关键因素：老年人口的急剧增加、新一代老年人、政府角色受限、代际紧张关系、企业关注度不断提高以及“老年技术”的兴起。这些趋势和反趋势将使长期护理领域呈现新面貌。到2010年，变化将包括真正的公私融资体系、基于人头费和预期支付的提供者报销、服务的协调获取、占主导地位的替代交付系统、不同类型的疗养院、人员配备问题减少、以患者为中心的护理、住房方面的新重要性以及对预防的重视。对医院来说，这种长期护理的未来愿景意味着将出现大量机会，以满足高危老年人的需求，并在蓬勃发展的老年护理行业中占据竞争地位。
