Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
Division of Geriatric Medicine and Palliative Care, School of Medicine, New York University, New York, NY, USA.
Alzheimers Dement. 2017 Oct;13(10):1168-1173. doi: 10.1016/j.jalz.2017.09.001. Epub 2017 Sep 18.
There is now an unprecedented opportunity to improve the care of the over 5 million people who are living with Alzheimer's disease and related dementias and many more with cognitive impairment due to brain injury, systemic diseases, and other causes. The introduction of a new Medicare care planning benefit-long sought openly by advocacy organizations and clinicians and badly needed by patients and families-could greatly improve health care quality, but only if widely and fully implemented. We describe the components of this new benefit and its promise of better clinical care, as well as its potential to create a new platform for clinical and health outcomes research. We highlight external factors-and some that are internal to the benefit structure itself-that challenge the full realization of its value, and we call for broad public and professional engagement to ensure that it will not fail.
现在有一个前所未有的机会来改善超过 500 万患有阿尔茨海默病和相关痴呆症的人的护理，以及更多因脑损伤、系统性疾病和其他原因导致认知障碍的人。引入新的医疗保险护理计划福利——这是倡导组织和临床医生长期公开寻求的，也是患者和家庭迫切需要的——可以大大提高医疗保健质量，但前提是广泛而全面地实施。我们描述了这项新福利的组成部分及其为更好的临床护理带来的承诺，以及它为临床和健康结果研究创造新平台的潜力。我们强调了一些挑战该福利充分发挥其价值的外部因素，以及一些内在的福利结构本身的因素，我们呼吁广泛的公众和专业参与，以确保该福利不会失败。
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