Department of Social Medicine, Public Health School, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, PR China.
Arch Gerontol Geriatr. 2011 May-Jun;52(3):e106-9. doi: 10.1016/j.archger.2010.08.005. Epub 2010 Oct 30.
The purpose of this study is to provide the evidence of individualized/personalized care by evaluating multi-dimensional outcomes of chronic diseases in the elderly. We used primary osteoporosis as an example, to evaluate the outcomes of three treatments (calcium combined vitamin D=Ca+vit.D; estrogen and disphosphonates) at the same time with biological dimension (bone-mineral density=BMD) and socio-psychological dimension (health-related quality of life=HR-QOL), using the medical outcomes study short-form 36-item health survey (SF-36) and cost dimension (drug cost). Using BMD as the outcome index, disphosphonate was the most effective treatment, in terms of HR-QOL, estrogen was the most effective while Ca+vit.D was the cheapest treatment, namely, different dimensional outcomes with different results. Outcome evaluation of chronic diseases in the elderly needs to combine psychological and socio-economic parameters together with the physiological measurement, to encourage a transition from "the disease-centered" to "the patient-centered" perspective as well as achieve sustainable and coordinated development of health and socio-economic resources.
本研究旨在通过评估老年人慢性病的多维结局提供个体化/个性化护理的证据。我们以原发性骨质疏松症为例，同时使用生物维度（骨矿物质密度=BMD）和社会心理维度（健康相关生活质量=HR-QOL），以及成本维度（药物成本），用医疗结局研究简表 36 项健康调查（SF-36）评估三种治疗方法（钙加维生素 D=Ca+vit.D；雌激素和双磷酸盐）的结局。以 BMD 为结局指标，双磷酸盐治疗最有效，在 HR-QOL 方面，雌激素最有效，而 Ca+vit.D 则是最便宜的治疗方法，即不同维度的结局有不同的结果。老年人慢性病的结局评估需要将心理和社会经济参数与生理测量相结合，鼓励从“以疾病为中心”向“以患者为中心”的转变，并实现卫生和社会经济资源的可持续和协调发展。
