Landefeld C Seth
Division of Geriatrics, Box 1265, University of California, San Francisco, San Francisco, CA 94143-1265, USA.
Ann Intern Med. 2003 Sep 2;139(5 Pt 2):421-4. doi: 10.7326/0003-4819-139-5_part_2-200309021-00008.
Health care of the highest quality promotes successful aging. This paper examines the efforts that have been taken to improve the quality of health care, especially hospital care. Most of these efforts have evaluated conventional treatments of specific diseases; they are critical but underfunded and underused, and many practices persist without much evidence of efficacy. Fewer efforts have attempted to improve care for groups of persons in specific settings, such as the hospital. Three complementary approaches to improving comprehensive outcomes for hospitalized older persons-Geriatric Evaluation and Management, Acute Care for Elders, and the Elder Life Program-demonstrate what has been learned about improving care for older persons by redesigning microsystems of care. A research agenda for advancing successful aging should include specific actions to improve the quality of health care.
高质量的医疗保健有助于成功老龄化。本文探讨了为提高医疗保健质量，尤其是医院护理质量所做的努力。这些努力大多评估了特定疾病的传统治疗方法；它们很关键，但资金不足且未得到充分利用，而且许多做法在缺乏充分疗效证据的情况下仍在持续。试图改善特定环境（如医院）中人群护理的努力较少。三种改善住院老年人综合结局的互补方法——老年评估与管理、老年急性护理和老年生活项目——展示了通过重新设计护理微系统在改善老年人护理方面所学到的经验。推进成功老龄化的研究议程应包括提高医疗保健质量的具体行动。
