Robin Osborn (
Michelle M. Doty is vice president of survey research and evaluation at the Commonwealth Fund.
Health Aff (Millwood). 2017 Dec;36(12):2123-2132. doi: 10.1377/hlthaff.2017.1048. Epub 2017 Nov 15.
High-income countries are grappling with the challenge of caring for aging populations, many of whose members have chronic illnesses and declining capacity to manage activities of daily living. The 2017 Commonwealth Fund International Health Policy Survey of Older Adults in eleven countries showed that US seniors were sicker than their counterparts in other countries and, despite universal coverage under Medicare, faced more financial barriers to health care. The survey's findings also highlight economic hardship and mental health problems that may affect older adults' health, use of care, and outcomes. They show that in some countries, one in five elderly people have unmet needs for social care services-a gap that can undermine health. New to the survey is a focus on the "high-need" elderly (those with multiple chronic conditions or functional limitations), who reported high rates of emergency department use and care coordination failures. Across all eleven countries, many high-need elderly people expressed dissatisfaction with the quality of health care they had received.
高收入国家正在努力应对老龄化人口的挑战,这些人口中的许多人都患有慢性疾病,日常生活活动能力下降。2017 年英联邦基金对 11 个国家的老年人口国际健康政策调查显示,美国老年人比其他国家的同龄人病得更重,尽管医疗保险覆盖范围广泛,但他们在获得医疗保健方面面临更多的经济障碍。该调查的结果还突出了可能影响老年人健康、护理使用和结果的经济困难和心理健康问题。调查显示,在一些国家,五分之一的老年人有未得到满足的社会护理服务需求——这一差距可能会损害健康。该调查的新重点是关注“高需求”老年人(患有多种慢性疾病或功能障碍的老年人),他们报告说急诊部门使用率和护理协调失败率很高。在所有 11 个国家中,许多高需求的老年人对他们所接受的医疗保健质量表示不满。