改进美国老年人的健康和医疗卫生英文文献及翻译

改进美国老年人的健康和医疗卫生英文文献及翻译内容摘要：

uch as capitation and prospective payment for skilled nursing home care and quality measurement and reporting. There are many unanswered questions about the effect of these changes on quality and cost Providing and Financing Health Care Services for Older People The unique challenges in providing and financing health care services for older people require a targeted research focus. Caring for older people involves clinical plexities that are difficult to coordinate at the health system level and because of fragmented financing, are also difficult to manage financially. Aging results in both pathophysiologic and pharmacokiic changes that must be addressed in clinical practice. Comorbidity is mon, presenting a challenge to clinical management. Endoflife decisionmaking grows in importance, focusing attention on quality of life. Family members often play an important role in providing and managing care, and require education, support, and assistance in these tasks. Nevertheless, the majority of older people remain active and independent and the prevention of disability among this group of elders is critical. Effective and efficient care for older people therefore requires new models of coordination among preventive, acute, chronic, rehabilitative, and longterm care services. Furthermore, financing of care to older people is fragmented and improved models of care will depend on appropriate payment models. Improving the quality of care for older people is likely to have a substantial impact on their functional status and therefore their quality of life. The underuse of effective interventions, the overuse of interventions shown to be ineffective, and the misuse of others especially polypharmacy have all been well documented in the elderly. Many doctors do not routinely assess the functional status of their older patients, nor do they have the knowledge and skills requisite for geriatric practice. Quality measures are needed to assess the effectiveness of interventions to improve care in these areas. While the unique constellation of issues confronting the elderly described here necessitates。