Konkuk University Medical Center, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, South Korea.
Yonsei University College of Medicine Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, 06273, South Korea.
BMC Geriatr. 2020 Jan 31;20(1):32. doi: 10.1186/s12877-019-1397-3.
In the age of aging, Korea's current medical delivery system threatens to increase the number of medical and caring refugees. This study attempts to develop an integrated senior citizen-oriented healthcare service system in which daily care, professional care, and rehabilitation are organically organized between medical institutions and local communities, thereby meeting the daily life needs of the elderly and inducing well-being, wellness, and well-dying.
To develop the integrated healthcare system, data collection and analyses were conducted through a systematic review, literature review, benchmarking, focus group interviews, and expert consultation.
The senior-specific, citizen-oriented healthcare service system developed in this study is designed to screen patients aged 65 or older within 24 h of being admitted, using the Geriatric Screening for Care-10. If there is reason for concern as a result of the screening, further evaluation is performed through assessment. Doctors and nurses create a care plan and a discharge plan based on the results from the screening and assessment. The nurse further uses the screening to monitor the patient's condition before discharge. Based on the screening results at the time of discharge, a transitional care plan is prepared and provided to elderly patients and/or their families. This process enables a systematic link between medical institutions and community resources, aiming for the continuous management of health issues. It also establishes a multidisciplinary treatment plan that considers patients and their families so that diseases common to the elderly are diagnosed and treated promptly.
The most important issue for the elderly is to be able to live healthily and independently for the rest of their lives through well-being, wellness, and well-dying. The senior-specific, citizen-oriented healthcare service proposed in this study is an integrated medical treatment system for elderly users the implementation of which requires the daily care, professional care, and rehabilitation of elderly members of society to be organically organized according to the role of the patients, their families, and the caregiver.
在老龄化时代，韩国当前的医疗输送系统有可能增加医疗和护理难民的数量。本研究试图开发一个综合的面向老年人的医疗保健服务系统，在该系统中，医疗机构和当地社区之间有机地组织日常护理、专业护理和康复，从而满足老年人的日常生活需求，并诱导幸福感、健康感和善终感。
为了开发综合医疗保健系统，通过系统评价、文献回顾、基准测试、焦点小组访谈和专家咨询进行了数据收集和分析。
本研究开发的面向老年人的公民医疗保健服务系统旨在对 65 岁或以上的患者在入院后 24 小时内进行筛查，使用老年护理筛查量表-10（Geriatric Screening for Care-10）进行筛查。如果筛查结果有问题，则通过评估进行进一步评估。医生和护士根据筛查和评估的结果制定护理计划和出院计划。护士在出院前进一步使用筛查来监测患者的病情。根据出院时的筛查结果，为老年患者及其家属制定过渡性护理计划并提供该计划。这个过程使医疗机构和社区资源之间建立了系统联系，旨在对健康问题进行持续管理。它还建立了一个多学科的治疗计划，考虑到患者及其家属，以便及时诊断和治疗老年人常见的疾病。
老年人最重要的问题是通过幸福感、健康感和善终感，能够健康、独立地度过余生。本研究提出的面向老年人的公民医疗保健服务是一个综合的老年用户医疗系统，其实施需要根据患者、其家属和护理人员的角色，有机地组织社会老年人的日常护理、专业护理和康复。
