Department of Internal Medicine-Section on Gerontology & Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
MedStar Good Samaritan Hospital, Baltimore, Maryland.
J Am Geriatr Soc. 2019 Jan;67(1):139-144. doi: 10.1111/jgs.15670. Epub 2018 Nov 28.
Home-based primary care (HBPC) is experiencing a reemergence to meet the needs of homebound older adults. This brief review based on existing literature and expert opinion discusses 10 key facts about HBPC that every geriatrician should know: (1) the team-based nature of HBPC is key to its success; (2) preparations and after-hour access for house calls are required; (3) home safety for the clinician and patient must be considered; (4) being homebound is an independent mortality risk factor with a high symptom burden; (5) home care medicine presents unique benefits and challenges; (6) a systems-based approach to care is essential; (7) HBPC is a sustainable model within value-based care proven by the Department of Veterans Affairs and the Independence at Home Medicare Demonstration Project; (8) HBPC has an educational mission; (9) national organizations for HBPC include American Academy of Home Care Medicine and Home Centered Care Institute; and (10) practicing HBPC is a privilege. HBPC is a dynamic and unique practice model that will continue to grow in the future. J Am Geriatr Soc 67:139-144, 2019.
家庭为基础的初级保健(HBPC)正在重新出现,以满足居家老年患者的需求。本综述基于现有文献和专家意见,讨论了每一位老年医学专家都应该了解的关于 HBPC 的 10 个关键事实:(1)HBPC 的团队性质是其成功的关键;(2)需要为家访做好准备并提供下班后的联系方式;(3)必须考虑临床医生和患者的家庭安全;(4)居家是独立的死亡风险因素,伴有高症状负担;(5)家庭护理医学具有独特的益处和挑战;(6)以系统为基础的护理方法至关重要;(7)家庭为基础的初级保健在基于价值的医疗保健中是一种可持续的模式,这已被退伍军人事务部和独立居家医疗保险示范项目所证明;(8)家庭为基础的初级保健具有教育使命;(9)家庭为基础的初级保健的全国性组织包括美国家庭医疗保健学院和家庭为中心护理研究所;(10)从事家庭为基础的初级保健是一种特权。家庭为基础的初级保健是一种充满活力和独特的实践模式,未来将继续发展。《美国老年医学会杂志》67:139-144, 2019。