Tinetti Mary E, Esterson Jessica, Ferris Rosie, Posner Philip, Blaum Caroline S
Section of Geriatrics, Department of Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208025, New Haven, CT 06520, USA; Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.
Section of Geriatrics, Department of Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208025, New Haven, CT 06520, USA.
Clin Geriatr Med. 2016 May;32(2):261-75. doi: 10.1016/j.cger.2016.01.012. Epub 2016 Feb 28.
Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.
患有多种疾病的老年人接受的护理往往是分散的、负担沉重的，且益处不明确。一个由患者、护理人员、临床医生、卫生系统工程师、医疗保健系统领导者、支付方及其他人员组成的咨询小组确定了造成这种分散、负担沉重护理的三个可改变因素：决策和护理以疾病而非患者为重点；临床医生之间角色、责任和问责的划分不充分；以及对患者和护理人员重要的事项（即他们的健康结果目标和护理偏好）缺乏关注。该咨询小组将以患者优先为导向的护理确定为解决这些可改变因素的一种可行、可持续的方法。
