Fragmentation of care for frail older people - an international problem. Experience from three countries: Israel, Canada, and the United States
Fragmentation of care for frail older people - an international problem. Experience from three countries: Israel, Canada, and the United States
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DOI：
10.1046/j.1532-5415.2001.49285.x
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发表时间：
2001-12-01
影响因子：
6.3
通讯作者：
Kane, R
中科院分区：
文献类型：
--
作者：
Clarfield, AM;Bergman, H;Kane, R
医疗保健系统的跨国比较可以帮助我们更好地了解它们，并为这些司法管辖区内发现的问题提供可能的解决方案。由于在大多数医疗保健系统中存在的多个不连续性干扰了对体弱老年人的适当临床护理，我们有兴趣比较三个国家的医疗保健系统明显不同的情况。在光谱的一端，我们发现加拿大，一个几乎完全社会化的系统。另一个是美国，在那里，市场力量被允许在任何发达国家中最自由地发挥作用。以色列提供了一个与美国和加拿大的制度具有共同要素的中间模式。虽然本文所述的问题可以在“微观”层面上解决，但只有通过改善国家护理制度的结构和组织，才能真正改善照顾体弱老年人的适当条件。这种国际比较为这三个州以及其他国家的政策制定者提供了见解。
Cross-national comparisons of healthcare systems can help us to better understand them and to offer possible solutions for problems identified within these jurisdictions. Because multiple discontinuities present in most healthcare systems interfere with the appropriate clinical care of frail older people, we were interested in comparing the situation in three countries with markedly different healthcare systems. At one end of the spectrum we find Canada, with an almost fully socialized system. At the other stands the United States, where market forces are allowed the freest rein in any developed nation. Israel offers an intermediate model with elements held in common with both the U.S. and Canadian systems.Although the problems outlined in this paper can be addressed at the "micro" level, it is through an improvement in the structuring and organization of national systems of care that the appropriate conditions for the care of frail older people can be truly bettered. This international comparison offers insights for policy makers in these three states in particular and other countries in general.