Managing patient and system complexities to improve the quality and outcomes of chronic care: papers from VA's state-of-the-art conference: managing complexity in chronic care".
Managing patient and system complexities to improve the quality and outcomes of chronic care: papers from VA's state-of-the-art conference: managing complexity in chronic care".
复制标题
管理患者和系统的复杂性，以提高慢性护理的质量和结果：VA最新会议的论文：管理慢性护理中的复杂性”。
DOI：
10.1007/s11606-007-0381-3
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发表时间：
2007-12
影响因子：
5.7
通讯作者：
Kupersmith J
中科院分区：
文献类型：
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作者：
Kupersmith J
据估计，美国有超过 1.2 亿人患有慢性疾病，其中 24% 患有三种或以上疾病。 1 总体而言，退伍军人比一般人群病情更重、年龄更大，而且很大一部分人患有一种或多种慢性病。例如，近 20% 的退伍军人患有 2 型糖尿病；缺血性心脏病是退伍军人管理局最常见的住院指征；抑郁症和精神分裂症占 VA 总医疗费用的 25% 以上；退伍军人管理局是美国最大的艾滋病毒护理服务提供者。此外，退伍军人管理局现在正在照顾在伊拉克自由行动（OIF）和持久自由行动（OEF）中服役的新一代退伍军人。这些退伍军人中的许多人遭受过多发性（多系统/多器官）伤害，包括创伤性脑损伤和肢体丧失。这些新退伍军人在管理复杂的慢性病护理方面给我们的医疗保健系统带来了新的挑战。退伍军人管理局不仅必须为多处受伤的退伍军人提供尽可能最好的护理，我们还必须帮助这些年轻退伍军人学会应对和生活慢性病。退伍军人管理局和其他医疗保健组织面临的挑战是如何最好地为有复杂慢性护理需求的患者提供服务。鉴于临床指南是针对个体疾病量身定制的，治疗多种慢性疾病可能特别困难，并且专业护理可能涉及多个提供者，需要共同努力提供以患者为中心的协调护理。
It is estimated that more than 120 million people in the United States have a chronic health condition, and 24% of those have three or more conditions. 1 Overall, the veteran population is sicker and older than the general population, and a large proportion suffer from one or more chronic illnesses. For example, type 2 diabetes affects nearly 20% of veterans; ischemic heart disease is the most frequent indication for hospitalization in the VA; depression and schizophrenia account for more than 25% of VA’s total healthcare costs; and VA is the largest single provider of HIV care in the United States. Moreover, VA is now caring for a new generation of veterans who served during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Many of these veterans have suffered polytraumatic (multi-system/multi-organ) injuries, including traumatic brain injury and loss of limbs. These new veterans present our health care system with new challenges in terms of managing complex chronic care. Not only must VA provide the best care possible for veterans with multiple injuries, we also must help these young veterans learn to cope and live with chronic illness.The challenge to VA and other health care organizations is how best to serve patients with complex chronic care needs. Treating multiple chronic illnesses can be particularly difficult given that clinical guidelines are tailored to individual illnesses, and specialized care may involve multiple providers that need to work together to provide patient-centered, coordinated care.