Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Box 201, Lebanon, NH 03766, USA.
The Dartmouth Institute for Health Policy and Clinical Practice, 46 Centerra Parkway, Box 201, Lebanon, NH 03766, USA.
Clin Geriatr Med. 2020 May;36(2):341-352. doi: 10.1016/j.cger.2019.11.012.
The excess risk of early mortality, medical comorbidity, early institutionalization, and high costs among older adults with serious mental illness necessitates development and dissemination of effective and sustainable integrated care models that simultaneously address mental and physical health needs. This overview highlights current, evidence-based integrated care models, which predominantly adopt the following approaches: (1) psychosocial skills training, (2) integrated illness self-management, and (3) collaborative care and behavioral health homes. Finally, innovative models that build on these approaches by incorporating novel uses of telehealth, mobile health technology and peer support, and strategies from developing economies are discussed.
严重精神疾病老年患者的早亡风险、合并医学病症、早期机构化和高医疗费用过高,这需要开发和传播有效且可持续的综合护理模式,同时满足精神和身体健康需求。本综述重点介绍了当前基于证据的综合护理模式,主要采用以下方法:(1)心理社会技能培训,(2)综合疾病自我管理,以及(3)协作护理和行为健康之家。最后,还讨论了通过结合远程医疗、移动健康技术和同伴支持的新用途以及来自发展中经济体的策略来对这些方法进行创新的模式。