Acute Care vs. Chronic Care Models of Service to the Elderly

1993 ◽  
Vol 6 (4) ◽  
pp. 55-66
Author(s):  
Miriam P. Lahey
2016 ◽  
Vol 73 (6) ◽  
pp. 327-332
Author(s):  
Claudia Gerhards ◽  
Claudia Gregoriano ◽  
Cora Moser ◽  
Thomas Dieterle ◽  
Jörg Leuppi

Zusammenfassung. Die chronisch obstruktive Lungenerkrankung (COPD) ist vor allem unter Rauchern eine weit verbreitete Krankheit in der Schweiz. Der Verlauf ist oft progredient und die chronisch kranken und oft polymorbiden Patienten sind auf funktionierende Behandlungsnetzwerke angewiesen. Gesundheitspolitisch und auch medizinisch ist mehr Netzwerkdenken gefragt und notwendig und die Erarbeitung von eines chronic care models (CCM) äusserst sinnvoll. Die Basis dafür ist das evidenz-basierte Vorgehen. In diesem Artikel werden die Guidelines zur Diagnostik und Behandlung der COPD und deren Implementierung beleuchtet. Vorwegzunehmen ist, dass bereits ein breites Behandlungsangebot besteht und viele innovative Projekte lanciert wurden, um die Behandlungsqualität der COPD zu optimieren.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maki Asada ◽  
Motoyuki Horii ◽  
Kazuya Ikoma ◽  
Tsuyoshi Goto ◽  
Naoki Okubo ◽  
...  

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Carol Davy ◽  
Jonathan Bleasel ◽  
Hueiming Liu ◽  
Maria Tchan ◽  
Sharon Ponniah ◽  
...  

1988 ◽  
Vol 4 (2) ◽  
pp. 144-149 ◽  
Author(s):  
J. Kane ◽  
E. Leavitt ◽  
R. C. Summerbell ◽  
S. Krajden ◽  
S. S. Kasatiya

2011 ◽  
Vol 6 (6) ◽  
pp. 313-321 ◽  
Author(s):  
Heidi L. Wald ◽  
Jeffrey J. Glasheen ◽  
Jeannette Guerrasio ◽  
Jean M. Youngwerth ◽  
Ethan Ulysses Cumbler

Author(s):  
Lotte M. Barmentloo ◽  
Manon L. Dontje ◽  
Moniek Y. Koopman ◽  
Branko F. Olij ◽  
Christian Oudshoorn ◽  
...  

We aimed to gain insight into the barriers and facilitators to fall risk screening of older adults visiting the hospital as experienced by patients and healthcare professionals, and to examine the differences between chronic- and acute-care patients. We invited patients (≥ 70 years) attending the nephrology and emergency department to participate in the screening. Patients and their healthcare professionals were asked to complete a self-administered questionnaire based on the “Barriers and Facilitators Assessment Instrument”. Differences in barriers and facilitators between acute- and chronic-care patients were examined with chi-square tests. A total of 216 patients were screened, and 103 completed the questionnaire. They considered many factors as facilitators, and none as barriers. Acute-care patients were more positive than chronic-care patients about healthcare worker characteristics, such as knowledge and skills. After screening, patients were more open to receiving advice regarding fall prevention. The 36 healthcare professionals considered program characteristics to be facilitators and mainly factors regarding healthcare worker characteristics as barriers to implementation. For patients, the outpatient setting seemed to be a good place to be screened for fall risk. Healthcare professionals also suggested that program characteristics could enhance implementation. However, healthcare professionals’ mindsets and the changing of routines are barriers that have to be addressed first.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033929
Author(s):  
Renata Josi ◽  
Monica Bianchi

ObjectivesWe aimed to analyse roles and tasks of advanced practice nurses (APNs), registered nurses (RNs) without advanced practice education and medical practice assistants (MPAs) with regard to chronic care in Swiss primary care (PC). The objective of this study was to explore the potential of new care models, involving these health professionals, which could meet changing future healthcare needs.DesignAn ethnographic design comprising semi-structured interviews and non-participant observations was conducted.SettingHealth professionals who worked in 10 primary care practices in the German-speaking part of Switzerland were included in the study.ParticipantsIn total, 16 interviews were conducted with four APNs, six MPAs, two RNs and four general practitioners (GPs). Nine of the health professionals were subsequently observed in their primary care practice.ResultsAPNs and MPAs were both involved in chronic care in the PC practice. While APNs cared for older, multimorbid patients with more complex needs, MPAs were involved in counselling of younger patients with chronic disease such as type 2 diabetes. Additionally, APNs were involved in many home visits and visits in elderly peoples — and nursing homes. APNs worked with a high degree of autonomy while MPAs had worked mostly in delegation. Task division between GPs and APNs or MPAs was not clear in every case yet.ConclusionsAPNs and MPAs have a high potential to contribute to optimal care in new care models, which address needs of the elderly population. The experience from our sample may inform international health policymakers and practitioners about the tasks and responsibilities those health professionals can take over in PC when implementing new models of care. The practical experience with new models of care involving APNs and MPAs may also influence the future regulation with regard to the scope of practice of these health professionals in Switzerland.


Medical Care ◽  
2013 ◽  
Vol 51 (10) ◽  
pp. 922-930 ◽  
Author(s):  
Christopher J. Miller ◽  
Andrew Grogan-Kaylor ◽  
Brian E. Perron ◽  
Amy M. Kilbourne ◽  
Emily Woltmann ◽  
...  

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