Division of Geriatric, Department of Medicine, University of California, San Francisco, CA, USA.
Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco, CA, USA.
J Gen Intern Med. 2020 Nov;35(11):3338-3341. doi: 10.1007/s11606-020-06010-x. Epub 2020 Jul 6.
The safety net, a collection of public hospitals, federally qualified health centers (FQHCs), and publicly funded community-based healthcare entities, provides essential care to middle-aged and older adults with geriatric conditions. The role of the safety net for these adults will intensify over the next two decades with the growing numbers of middle-aged and older adults with adverse social determinants of health and premature geriatric conditions. The foundation for addressing their needs is to detect geriatric conditions and then focus care plans on the impact of these factors on function, which predicts mortality and quality of life more than chronic conditions alone. To detect geriatric conditions in safety net populations, the Age-Friendly Health System (AFHS) framework offers an evidence-based focus on the 4Ms: Mentation, Mobility, Medications, and what Matters. Further incorporating geriatric care models that target the 4Ms and are adapted to safety net populations will enable age-friendly care that optimizes health and addresses what matters to older people.
安全网是由公立医院、联邦合格的健康中心 (FQHC) 和公共资助的社区医疗实体组成的集合，为患有老年病的中年和老年人提供基本护理。在未来二十年，随着越来越多的中年和老年人出现不良健康社会决定因素和过早的老年病，安全网对这些成年人的作用将加强。解决他们需求的基础是检测老年病，然后将护理计划重点放在这些因素对功能的影响上，这比仅关注慢性病更能预测死亡率和生活质量。为了在安全网人群中检测老年病，友好型老年健康系统 (AFHS) 框架提供了一个基于证据的重点关注 4Ms：认知、移动、药物和重要事项。进一步纳入针对 4Ms 的老年护理模式，并使其适应安全网人群，将能够提供友好型护理，优化健康状况，并解决老年人关心的问题。
