Early in my intern year, I admitted an 80-year-old man with pneumonia to the intensive care unit (ICU). He had hypotension and was struggling to breathe, and my senior resident and I told his family that it was touch and go. Their response: Do everything. He had repaired cars for a living, and he was a tough guy, a fighter.
Durante las discusiones en el Forum de Longevidad de Brasil de 2013 se subrayó la necesidad de un cuidado integral, enfocado en la persona, firmemente sustentado en los derechos humanos; la importancia de los entornos amigables con la edad; el valor del contexto cultural del cuidado en el panorama internacional; y las múltiples dimensiones de la atención, incluyendo aquella que se brinda en el contexto de situaciones de emergencia y al final de la vida.
Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules.
This paper studies a model of community-based healthcare delivery for a chronic disease. In this setting, patients periodically visit the healthcare delivery system, which influences their disease progression and consequently their health outcomes.
To explore central challenges with translating self-reported measurement tools for functional status and health-related quality of life (HRQOL) into ambulatory quality indicators for older people with multiple chronic conditions (MCCs).
Many patients with long-term conditions have multiple conditions. Current delivery of care is not designed around their needs and they may face barriers to effective self-management. This study assessed the relationships between multimorbidity, the delivery of care, and self-management.
The rising burden of chronic conditions has led several European countries to reform healthcare payment schemes. This paper aimed to explore the adoption and success of payment schemes that promote integration of chronic care in European countries.
Primary care provides most of the evidence-based chronic disease prevention and screening services offered by the healthcare system. However, there remains a gap between recommended preventive services and actual practice. This trial (the BETTER Trial) aimed to improve preventive care of heart disease, diabetes, colorectal, breast and cervical cancers, and relevant lifestyle factors through a practice facilitation intervention set in primary care.
As life expectancy continues to rise, more elderly are reaching advanced ages (>=80 years). The increasing prevalence of multimorbidity places additional demands on health-care resources for the elderly. Previous studies noted the impact of multimorbidity on the use of health services, but the effects of multimorbidity patterns on health-service use have not been well studied, especially for very old people. This study determines patterns of multimorbidity associated with emergency-room visits and hospitalization in an 85-year-old ...
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