MacLeod Stephanie, Schwebke Kay, Hawkins Kevin, Ruiz Joann, Hoo Emma, Yeh Charlotte S
1 Advanced Analytics , Optum, Ann Arbor, Michigan.
2 Quality Measurement , Optum, Eden Prairie, Minnesota.
Popul Health Manag. 2018 Aug;21(4):296-302. doi: 10.1089/pop.2017.0109. Epub 2017 Oct 24.
Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.
研究表明，老年人仅获得约一半他们应得的护理，护理质量参差不齐，且通过最常用的质量衡量标准对影响其健康的社会问题关注有限。此外，许多现有衡量标准忽视了健康的非临床社会决定因素。对老年人采取更全面衡量标准的必要性的证据日益增多。本文的主要目的（这得到了有限的文献综述的支持）是描述当前质量衡量标准在满足老年人某些非临床需求（包括健康的关键社会决定因素）方面存在的差距。在此过程中，作者阐述了他们对于需要扩大衡量标准以纳入这些因素以改善护理和生活质量的立场。作者对文献进行了有限的综述以撰写本文，特别关注针对老年人的选定衡量标准，而非对所有衡量标准进行更广泛的系统综述。所确定的大多数研究与临床实践指南相关，而非适用于老年人的护理质量衡量标准。此外，所审查的文献反映出为满足老年人独特社会需求而量身定制质量衡量标准的努力的证据有限，证实了这一领域存在潜在差距。越来越需要改进专门设计的质量衡量标准，以帮助提供者满足老年人独特的社会需求。填补这一差距将增进对老年人的全面了解，并帮助他们实现最佳健康状态和成功老龄化。
