Patient Priority-Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions

被引:96
作者
Tinetti, Mary E. [1 ,2 ]
Esterson, Jessica [1 ]
Ferris, Rosie [3 ,4 ]
Posner, Philip [5 ]
Blaum, Caroline S. [3 ,4 ]
机构
[1] Yale Univ, Sch Med, Dept Med, Sect Geriatr, 333 Cedar St,POB 208025, New Haven, CT 06520 USA
[2] Yale Univ, Sch Publ Hlth, 60 Coll St, New Haven, CT 06520 USA
[3] NYU, Langone Med Ctr, Dept Med, Div Geriatr Med & Palliat Care, 462 First Ave,C&D Bldg,Room CD612-613, New York, NY 10016 USA
[4] NYU, Langone Med Ctr, Dept Populat Hlth, 550 First Ave,BCD612, New York, NY 10016 USA
[5] Oak Ridge Associated Univ, Oak Ridge Inst Sci Educ, Oak Ridge, TN USA
关键词
Multiple chronic conditions; Fragmented and burdensome care; Patient priorities; Patient's health outcome goals and care preferences; Patient priority-directed care; Current care planning; HEALTH OUTCOME PRIORITIES; CLINICAL-TRIALS; MEDICARE; BURDEN; MULTIMORBIDITY; PREVENTION; FRAMEWORK;
D O I
10.1016/j.cger.2016.01.012
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.
引用
收藏
页码:261 / +
页数:16
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