Willging P
College of Allied Health Professions, University of Kentucky, Lexington, USA.
Clin Geriatr Med. 1995 Aug;11(3):531-45.
Anticipating the needs of aging baby boomers and responding to market demands for consumer choice and low-cost care, long-term care providers are changing the way they do business. As part of that change, they are offering new and, in some cases, more complex services at both the high and low end of the spectrum. At the high acuity end, long-term care providers are delivering hospital-like subacute care to increasing numbers of patients at roughly half the costs of providing the same care in hospitals. At the low acuity end, providers are offering new assisted living services, as well as a full range of community-based long-term care. At the same time, traditional nursing facilities continue to meet the needs of chronically ill elderly and people of all ages needing rehabilitative care. These changes point to a shifting role for physicians (and especially medical directors) in the long-term care setting.
为了满足婴儿潮一代老龄化的需求，并回应市场对消费者选择和低成本护理的要求，长期护理服务提供商正在改变他们的经营方式。作为这种变革的一部分，他们在服务范围的高端和低端都提供了新的、在某些情况下甚至更复杂的服务。在高 acuity 端，长期护理服务提供商正在以大约医院提供相同护理成本一半的价格，为越来越多的患者提供类似医院的亚急性护理。在低 acuity 端，服务提供商正在提供新的辅助生活服务，以及全方位的基于社区的长期护理。与此同时，传统的护理机构继续满足慢性病老年人以及所有需要康复护理的各年龄段人群的需求。这些变化表明医生（尤其是医疗主任）在长期护理环境中的角色正在发生转变。
