A STRATEGIC SUPPORTIVE MODEL FOR HEALTH PROMOTION MAINTENANCE IN THE ELDERLY

驱动这项研究的假设可以陈述如下： 旨在加强对疾病过程的了解的干预措施 老年人口将允许患者成为活跃的 参与小学、中学和大学的预防战略 水平将改善接受服务的人群中与健康相关的结果 我们的大学医院。在注重成本的环境中， 旨在重新重视健康促进和疾病的责任 对病人的预防更有可能成功。老年人 美国的人口占总人口的13%，而在 到2030年将占到23%。这些老年人口将 需要逐步增加医疗保健资金，以便 维持目前的护理水平。当前的综合模式 老年保健在大多数国家没有得到成功实施 由于成本和财政原因，社区和大学医院 在以下情况下，这些机构需要承担的责任 偿还不足，财政资源减少。这些问题是 在主要为少数群体服务的机构中尤其相关 人口。老年人保健接触的性质 对我们机构中的人口进行了分析。老年病患者 占医学部入院人数的44%-48%。他们 经常表现出某种程度的严重身体残疾。他们的 在许多情况下，对疾病过程的感知是不合适的 没有遵循具有成本效益的预防战略。特殊的社会 这一群体的脆弱性是有据可查的。尽管存在多个 适用于预防性老年病的领域存在一些障碍， 不允许最佳实施。假设项目旨在开发 通过病例护理对老年患者进行直接干预的模式 经理旨在通过发展更广泛的自我护理活动来增加自我护理活动 以及更有针对性的患者参与他/她的医疗保健决策。 这项初步研究将以随机方式进行，并将平局进行 在四年期间对多项成果评估进行评价。 这项研究可能会导致开发具有成本效益的护理模式 这可以在不增加健康的情况下延长健康寿命 护理费用。

The hypothesis which drives this study can be stated as follows: Interventions designed to enhance understanding of disease processes in the elderly population will allow the patient to become an active participant in preventive strategies in a primary, secondary and tertiary level would improve health related outcomes in the population served In our University Hospital. In a cost conscious environment, models which are geared to recenter the responsibility of health promotion and disease prevention to the patient are more likely to succeed.The elderly population in the United States represents 13% of the population and in the year 2030 will account for 23%. This geriatric population will require a progressive larger amount of health care dollars in order to maintain current levels of care. Current models for Comprehensive Geriatric care have not been successfully implemented in the majority of community and University Hospitals due to the cost and fiscal responsibilities the institutions would need to assume in a scenario of inadequate reimbursement and decreased fiscal resources. These issues are particularly relevant in institutions that predominantly serve minority populations. The nature of health care encounters of the geriatric population in our institution has been analyzed. Geriatric patients represent 44-48% of the admissions to the department of medicine. They frequently express some degree of significant physical disability. Their perception of disease process is not appropriate in many instances and cost-effective preventive strategies are not followed. The special social vulnerability of this population is well documented. In spite of multiple areas amenable to preventive geriatrics a number of barriers exist which do not allow optimal implementation. The ASSUME project aims to develop a model of direct intervention with geriatric patients via a Case Care Manager designed to increase self-care activities by developing a wider and more focused patient involvement in his/her health care decisions. This pilot study will be done in a randomized fashion and will be tied to the evaluation of multiple outcome assessments in a 4 year period. This study could lead to the development of cost effective models of care which could increase the span-of healthy life without increasing health care costs.