老年人综合医疗保健的成长烦恼：老年医疗保健计划（PACE）扩张的经验教训
The growing pains of integrated health care for the elderly: lessons from the expansion of PACE.
作者信息
Gross Diane L, Temkin-Greener Helena, Kunitz Stephen, Mukamel Dana B
机构信息
University of Rochester, USA.
出版信息
Milbank Q. 2004;82(2):257-82. doi: 10.1111/j.0887-378X.2004.00310.x.
Abstract
The early success of the demonstration Program of All-Inclusive Care for the Elderly (PACE) led to its designation as a permanent Medicare program in 1997. But the growth in the number of programs and enrollment has lagged and does not meet expectations. This article offers insights into the mechanisms influencing the expansion of PACE, from information obtained in interviews and surveys of administrators, medical directors, and financial officers in 27 PACE programs. Sixteen barriers to expansion were found, including competition, PACE model characteristics, poor understanding of the program among referral sources, and a lack of financing for expansion. This experience offers important lessons for providing integrated health care to the frail elderly.
摘要
老年人全面护理示范项目（PACE）早期取得的成功使其在1997年被指定为永久性医疗保险项目。但该项目数量和参保人数的增长滞后，未达预期。本文通过对27个PACE项目的管理人员、医疗主任和财务官员进行访谈和调查所获得的信息，深入探讨了影响PACE扩展的机制。研究发现了16个扩展障碍，包括竞争、PACE模式特点、转诊来源对该项目的了解不足以及缺乏扩展资金。这一经验为向体弱老年人提供综合医疗保健提供了重要教训。
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