Veteran's Affairs Home Based Primary Care
Veteran's Affairs Home Based Primary Care
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DOI：
10.1016/j.cger.2008.11.002
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发表时间：
2009-02-01
影响因子：
3.3
通讯作者：
Edes, Thomas
中科院分区：
文献类型：
--
作者：
Beales, Julie Leftwich;Edes, Thomas
为了应对慢性致残疾病退伍军人人口的预期增长，退伍军人事务部（VA）建立了基于家庭的初级保健（HBPC）。这篇文章的重点是这个项目，一个专门针对患有复杂慢性致残疾病的个人的家庭护理项目，其目标是最大限度地提高患者的独立性，减少可预防的急诊室就诊和住院。HBPC项目由一个跨学科团队在患有复杂慢性疾病的退伍军人家中提供全面的纵向初级保健，这些退伍军人无法通过常规的临床护理得到有效管理。HBPC在人口、流程和结果方面与标准的熟练家庭护理服务非常不同，并互为补充。HBPC针对的是患有晚期慢性疾病的人，而不是可治愈的人。HBPC提供多种合并症的综合护理，而不是以问题为重点的护理。HBPC由一个跨学科团队提供，而不是一两个独立的提供者。目前在四分之三的VA设施中运营，HBPC的扩展继续受到临床成功和所有VA服务的最高满意度的推动。VA HBPC是一种可模仿的模式，用于照顾患有复杂慢性残疾的人，在不增加成本的情况下提高质量，并通过在家中提供全面的纵向跨学科护理，最大限度地提高他们的独立性。
In response to the anticipated growth of the veteran population with chronic disabling diseases, the Department of Veterans Affairs (VA) established Home Based Primary Care (HBPC). This article focuses on that program, a home care program that specifically targets individuals with complex chronic disabling disease, with the goal of maximizing the independence of the patient and reducing preventable emergency room visits and hospitalizations. HBPC programs provide comprehensive longitudinal primary care by an interdisciplinary team in the homes of veterans with complex chronic disease, who are not effectively managed by routine clinic-based care. HBPC is very different from and complementary to standard skilled home care services, in population, processes and outcomes. HBPC targets persons with advanced chronic disease, rather than remediable conditions. HBPC provides comprehensive care of multiple co-morbidities, rather than problem-focused care. HBPC is delivered by an interdisciplinary team, rather than one or two independent providers. Currently operating in three-fourths of VA facilities, HBPC expansion continues to be driven by clinical success and the highest satisfaction of all VA services. VA HBPC is a model to emulate for the care of persons with complex, chronic disabling conditions, improving quality without added cost, and maximizing their independence through comprehensive longitudinal interdisciplinary care delivered in their homes.