Terry Fulmer (
David B. Reuben is director of the Multicampus Program in Geriatrics Medicine and Gerontology and chief of the Division of Geriatrics at the University of California Los Angeles Center for Health Sciences, in Los Angeles, California.
Health Aff (Millwood). 2021 Feb;40(2):219-225. doi: 10.1377/hlthaff.2020.01470. Epub 2021 Jan 21.
By 2030 more people in the United States will be older than age sixty-five than younger than age five. Our health care system is unprepared for the complexity of caring for a heterogenous population of older adults-a problem that has been magnified by the coronavirus disease 2019 (COVID-19) pandemic. Here, as part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2021 initiative, we identify six vital directions to improve the care and quality of life for all older Americans. The next administration must create an adequately prepared workforce; strengthen the role of public health; remediate disparities and inequities; develop, evaluate, and implement new approaches to care delivery; allocate resources to achieve patient-centered care and outcomes, including palliative and end-of-life care; and redesign the structure and financing of long-term services and supports. If these priorities are addressed proactively, an infrastructure can be created that promotes better health and equitable, goal-directed care that recognizes the preferences and needs of older adults.
到 2030 年，美国六十岁以上的人口将超过五岁以下的人口。我们的医疗保健系统尚未准备好应对照顾多样化老年人群体的复杂性——这一问题因 2019 年冠状病毒病（COVID-19）大流行而加剧。在此，作为美国国家医学院“健康与医疗保健重要方向：2021 年优先事项”倡议的一部分，我们确定了改善所有美国老年人护理和生活质量的六个重要方向。下一届政府必须创建一支准备充分的劳动力队伍；加强公共卫生的作用；纠正差异和不平等现象；开发、评估和实施新的护理提供方法；分配资源以实现以患者为中心的护理和结果，包括姑息治疗和临终关怀；并重新设计长期服务和支持的结构和融资。如果这些优先事项得到积极处理，可以创建一个基础设施，促进更好的健康和公平、有目标的护理，同时认识到老年人的偏好和需求。
