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[老年医学或医学的老年化:老年医学向何处去?]

[Geriatrics or geriatricization of medicine : Quo vadis geriatrics?].

作者信息

Kolb G F

机构信息

Abteilung für Innere Medizin, Fachbereich Geriatrie, Bonifatius Hospital Lingen, Medizinische Klinik, Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Universität Münster, Wilhelmstr. 13, 49808, Lingen (Ems), Deutschland.

出版信息

Z Gerontol Geriatr. 2017 Dec;50(8):657-665. doi: 10.1007/s00391-017-1281-8.

Abstract

This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence. This certainly includes the increasing acquisition of decentralized joint treatment concepts and geriatric counselling services in the future, in addition to the classical assessment instruments. Keywords in association with this are: traumatology and othopedics of the elderly, geriatric neurology and geriatric oncology. Interdisciplinary geriatric expertise is increasingly being requested. Outpatient structures have so far not been prioritized in geriatrics. An independent research is under construction and it is gratifying that academic interest in geriatrics seems to be increasing and new professorial chairs have been established. It is not possible to imagine our hospital without geriatrics; however, there is still a certain imbalance between the clearly increased number of geriatric hospital beds, the representation of geriatrics in large hospitals (e.g. specialized and maximum care hospitals and university clinics), the secure establishment in further education regulations and the lack of a uniform nationwide concept of geriatrics.

摘要

本文探讨了老年医学在未来是否会发生变化以及如何变化的问题,以及鉴于人口结构的变化,老年医学的发展趋势是更多地朝着进一步扩张的方向,还是更多地朝着各个专科医学领域的老年医学化方向发展。老年医学在各个联邦州的不同发展情况只能从历史角度去理解,并且在新的医院薪酬体系背景下,这绝对是个问题。老年医学是一个典型的跨学科专业,与其他专业仍存在界限划分问题,但尚未明确界定其核心竞争力。除了传统的评估工具外,未来肯定还包括越来越多地采用分散式联合治疗概念和老年医学咨询服务。与之相关的关键词有:老年创伤学与矫形外科学、老年神经病学和老年肿瘤学。对跨学科老年医学专业知识的需求日益增加。到目前为止,门诊机构在老年医学中尚未得到优先考虑。一项独立研究正在进行中,令人欣慰的是,对老年医学的学术兴趣似乎在增加,并且已经设立了新的教授职位。很难想象我们的医院没有老年医学;然而,在老年医院病床数量明显增加、大型医院(如专科医院、重症监护医院和大学诊所)中老年医学的占比、继续教育规定中的稳固地位以及缺乏全国统一的老年医学概念之间,仍然存在一定的不平衡。

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