Stephen Isaacs (
Paul S. Jellinek is a partner at Isaacs/Jellinek.
Health Aff (Millwood). 2019 Jan;38(1):164-168. doi: 10.1377/hlthaff.2018.05297.
Motivated by the increasing number of older people-many with chronic illnesses-and the lack of support for them, the John A. Hartford Foundation (JAHF) made improving the care of older adults one of its two priorities in 1983 and its sole priority in 1994. To accomplish this, the foundation adopted a two-part strategy: first, create a field of professionals capable of caring for an aging population, and second, test models of care for older adults. The JAHF steadfastly pursued that strategy until 2013, when it adopted an approach focused on advancing age-friendly health systems. Geriatrics is now a recognized medical, nursing, and social work specialty, although low reimbursement, the stigma associated with caring for older people, and low prestige discourage students from entering it. Foundation-funded models of care have proven viable, and one of them-palliative care-has been widely adopted. The JAHF focused on an important social need for more than three decades, and this targeted and consistent effort has magnified its impact.
受越来越多的老年人（其中许多人患有慢性病）以及对他们缺乏支持的影响，1983 年约翰·A·哈特福德基金会（JAHF）将改善老年人护理作为其两个优先事项之一，并在 1994 年将其作为唯一的优先事项。为了实现这一目标，该基金会采取了两部分策略：首先，培养能够照顾老龄化人口的专业人员；其次，测试针对老年人的护理模式。JAHF 一直坚持这一策略，直到 2013 年，它采用了一种专注于推进适合老年人的健康系统的方法。老年医学现在是一个公认的医学、护理和社会工作专业，尽管报酬低、照顾老年人的污名以及威望低阻碍了学生进入这个领域。基金会资助的护理模式已被证明是可行的，其中一种模式——姑息治疗——已被广泛采用。JAHF 关注了三十多年的一个重要社会需求，这种有针对性和持续的努力扩大了其影响力。
