Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini, 80131, Naples, Italy.
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Aging Clin Exp Res. 2018 Jul;30(7):703-712. doi: 10.1007/s40520-018-0920-2. Epub 2018 Feb 21.
The traditional model of care is based on "disease-centered" management that requires the organization of the hospital in specialized wards, to which the patient is assigned for the main disease. The growing need to optimize economical and human resources and to promote a global approach to the patient has led to the setting up of the intensity of care model. It is a health system based on a "patient-centered" approach, where the hospital is organized in departments dedicated to patients with homogenous needs of care. In Italy, intensity of care model is currently being tested in the hospital organization, where three levels of intensity are proposed: low, medium and high. The purpose of the following review is to describe the role and importance of the Geriatrician in each of these care settings and to highlight the contradiction of a National Health System which promotes the geriatric approach to all types of patients, but does not invest in the formation and integration of the figure of the Geriatrician in clinical practice, condemning it to marginalization or even extinction.
传统的医疗模式是以“疾病为中心”的管理模式,需要医院在专门的病房中组织起来,将患者分配到主要疾病的病房中。为了优化经济和人力资源,并促进对患者的全面治疗,人们越来越需要建立护理强度模式。这是一种基于“以患者为中心”的医疗系统,医院按照具有同质护理需求的患者来组织。在意大利,目前正在医院组织中测试护理强度模式,提出了低、中、高三级护理强度。以下综述的目的是描述老年病医生在这些护理环境中的作用和重要性,并强调国家卫生系统的矛盾,该系统提倡对所有类型的患者采用老年病方法,但不投资于老年病医生在临床实践中的培训和整合,使他们处于边缘化甚至消失的境地。