The John A. Hartford Foundation, New York, New York.
Institute for Healthcare Improvement, Cambridge, Massachusetts.
J Am Geriatr Soc. 2018 Jan;66(1):22-24. doi: 10.1111/jgs.15076. Epub 2017 Sep 6.
The unprecedented changes happening in the American healthcare system have many on high alert as they try to anticipate legislative actions. Significant efforts to move from volume to value, along with changing incentives and alternative payment models, will affect practice and the health system budget. In tandem, growth in the population aged 65 and older is celebratory and daunting. The John A. Hartford Foundation is partnering with the Institute for Healthcare Improvement to envision an age-friendly health system of the future. Our current prototyping for new ways of addressing the complex and interrelated needs of older adults provides great promise for a more-effective, patient-directed, safer healthcare system. Proactive models that address potential health needs, prevent avoidable harms, and improve care of people with complex needs are essential. The robust engagement of family caregivers, along with an appreciation for the value of excellent communication across care settings, is at the heart of our work. Five early-adopter health systems are testing the prototypes with continuous improvement efforts that will streamline and enhance our approach to geriatric care.
美国医疗体系正发生前所未有的变革，许多人高度警惕，试图预测立法行动。从以数量为导向转变为以价值为导向，加上激励措施和支付模式的改变，都将影响实践和医疗体系预算。与此同时，65 岁及以上人口的增长令人欣喜又令人畏惧。约翰·A·哈特福德基金会与改善医疗保健协会合作，设想未来一个适合老年人的医疗体系。我们目前正在为满足老年人复杂而相互关联的需求而开发新方法，这为建立一个更有效、以患者为中心、更安全的医疗体系提供了巨大的希望。积极主动的模式可以解决潜在的健康需求，预防可避免的伤害，并改善对有复杂需求的人的护理。强有力地让家庭照顾者参与进来，并认识到在护理环境中进行良好沟通的价值，是我们工作的核心。五个早期采用者医疗体系正在试用这些原型，进行持续改进，以简化和增强我们的老年护理方法。
