Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?
Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?
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DOI：
10.1186/s12877-016-0396-x
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发表时间：
2017-01-05
期刊：
影响因子：
4.1
通讯作者：
Stahl JE
中科院分区：
文献类型：
--
作者：
Batsis JA;Pletcher SN;Stahl JE
肥胖症的日益流行与老年人口的增加并行，造成功能障碍、养老院安置和早期死亡的风险增加。医疗保险和医疗补助中心认识到治疗肥胖的重要性，并在初级保健环境中制定了一项福利，以鼓励初级保健临床医生对受益人进行强化行为治疗。这项福利包括旨在解决老年人肥胖问题的频繁，简短的诊所访问。我们描述的挑战，在实施和交付到现实世界的设置。报告强调了农村地区面临的挑战，这些地区老年人口增长最快，肥胖率高，但劳动力短缺，缺乏专门服务。远程医疗的使用已成功地在其他专业实施，并可能是一个有用的模式，提供急需的强化行为治疗，特别是在遥远的，资源不足的环境。本次审查概述了当前福利面临的一些挑战，并提出了克服农村初级保健实施障碍的解决方案，包括人员配置模式的变化。需要建议扩大福利的覆盖范围，使非医生团队成员更具包容性，但也需要改善肥胖老年人远程医疗服务的报销。
The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity. We describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, but also workforce shortages and lack of specialized services are emphasized. The use of Telemedicine has successfully been implemented in other specialties and could be a useful modality in delivering much needed intensive behavioral therapy, particularly in distant, under-resourced environments. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models. Recommendations to extend the benefit’s coverage to be more inclusive of non-physician team members is needed but also for improvement in reimbursement for telemedicine services for older adults with obesity.
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影响因子：
6.3
作者：
Batsis JA;Gill LE;Masutani RK;Adachi-Mejia AM;Blunt HB;Bagley PJ;Lopez-Jimenez F;Bartels SJ
通讯作者：
Bartels SJ
DOI：
10.1111/j.1748-0361.2012.00411.x
发表时间：
2012
期刊：
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
影响因子：
--
作者：
Befort CA;Nazir N;Perri MG
通讯作者：
Perri MG
影响因子：
3.4
作者：
Davis, Ann McGrath;James, Rochelle L.;Malone, Brett
通讯作者：
Malone, Brett
影响因子：
4.7
作者：
Costa, Paulo Dias;Hipolito Reis, A.;Rodrigues, Pedro P.
通讯作者：
Rodrigues, Pedro P.
影响因子：
3.6
作者：
Davis, Ann McGrath;Sampilo, Marilyn;Malone, Brett
通讯作者：
Malone, Brett