老年医学服务中心 - 医院与社区服务提供者之间的协作衰弱管理模式。
Geriatric Services Hub - A Collaborative Frailty Management Model between The Hospital and Community Providers.
机构信息
Li Feng Tan, Alexandra Health Pte Ltd: National Healthcare Group, Singapore, Singapore, E-Mail:
出版信息
J Frailty Aging. 2023;12(4):316-321. doi: 10.14283/jfa.2023.23.
BACKGROUND
Frailty is an important geriatric syndrome especially with ageing populations. Frailty can be managed or even reversed with community-based interventions delivered by a multi-disciplinary team. Innovation is required to find community frailty models that can deliver cost-effective and feasible care to each local context.
OBJECTIVES
We share pilot data from our Geriatric Service Hub (GSH) which is a novel frailty care model in Singapore that identifies and manages frailty in the community, supported by a hospital-based multi-disciplinary team.
METHODS
We describe in detail our GSH model and its implementation. We performed a retrospective data analysis on patient characteristics, uptake, prevalence of frailty and sarcopenia and referral rates for multi-component interventions.
RESULTS
A total of 152 persons attended between January 2020 to May 2021. Majority (59.9%) were female and mean age was 81.0 ± 7.1 years old. One-fifth (21.1%) of persons live alone. Mean Charlson Co-morbidity Index was 5.2 ± 1.8. Based on the clinical frailty risk scale (CFS), 31.6% were vulnerable, 51.3% were mildly frail and 12.5% were moderately frail. Based on SARC-F screening, 45.3% were identified to be sarcopenic whilst 56.9% had a high concern about falling using the Falls-Efficacy Scale-International. BMD scans were done for 41.4% of participants, of which 58.7% were started on osteoporosis treatment. In terms of referrals to allied health professionals, 87.5% were referred for physiotherapy, 71.1% for occupational therapy and 50.7% to dieticians.
CONCLUSION
The GSH programme demonstrates a new local model of partnering with community service providers to bring comprehensive population level frailty screening and interventions to pre-frail and frail older adults. Our study found high rates of frailty, sarcopenia and fear of falling in community-dwelling older adults who were not presently known to geriatric care services.
背景
衰弱是一种重要的老年综合征，特别是在人口老龄化的情况下。通过多学科团队提供的基于社区的干预措施，可以对衰弱进行管理，甚至逆转衰弱。需要创新，以找到可以为每个当地环境提供具有成本效益和可行的护理的社区衰弱模型。
目的
我们分享了新加坡老年服务中心（GSH）的试点数据，这是一种新的衰弱护理模式，通过一个多学科的医院团队在社区中识别和管理衰弱。
方法
我们详细描述了我们的 GSH 模型及其实施情况。我们对患者特征、就诊率、衰弱和肌少症的患病率以及多组分干预措施的转介率进行了回顾性数据分析。
结果
2020 年 1 月至 2021 年 5 月期间，共有 152 人就诊。大多数（59.9%）为女性，平均年龄为 81.0±7.1 岁。五分之一（21.1%）的人独居。平均 Charlson 合并症指数为 5.2±1.8。根据临床衰弱风险量表（CFS），31.6%的人处于脆弱状态，51.3%的人处于轻度衰弱状态，12.5%的人处于中度衰弱状态。根据 SARC-F 筛查，45.3%的人被确定为肌少症，56.9%的人使用跌倒效能量表-国际（Falls-Efficacy Scale-International）对跌倒有高度担忧。对 41.4%的参与者进行了 BMD 扫描，其中 58.7%开始接受骨质疏松症治疗。在向联合健康专业人员转介方面，87.5%的人转介进行物理治疗，71.1%的人转介进行职业治疗，50.7%的人转介进行营养师治疗。
结论
GSH 项目展示了一种新的本地模式，与社区服务提供商合作，为脆弱和衰弱的老年人提供全面的人群水平的衰弱筛查和干预措施。我们的研究发现，在目前尚未接受老年护理服务的社区居住的老年人中，衰弱、肌少症和对跌倒的恐惧率很高。
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