Transformation of a Geriatric Department in China
- Autores: Birong Dong, Jirong Yue, Li Cao, Ming Yang, Ning Ge, Hao Qiukui, Lujia He, Ying Wang, Joseph H. Flaherty
- Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 66, Nº. 1, 2018, págs. 184-190
- Idioma: inglés
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Resumen
China has the world’s largest elderly population, and theoldest-old population, with a current disability rate greaterthan 50%, will triple in the next 35 years. The field ofgeriatrics is young, because almost all geriatric depart-ments were established after 2000, and so faces many chal-lenges. Management of diseases and hospital care is thefocus. Senior physicians were trained in other subspe-cialties, such as pulmonary or cardiology, and juniorphysicians entered geriatrics departments as masters ordoctorate students after medical school. The inadequacy ofpost-acute and long-term care facilities has caused longhospital stays. There are no national systematic geriatrictraining programs, national board examinations, or qualifi-cations in geriatrics. These challenges were used as aframework for guiding changes in the Department of Geri-atrics at West China Hospital, Sichuan University. Thesechanges have included international experiences and col-laboration for physicians and nurses, revision of depart-mental conferences, and special training for a uniquegroup of caregivers called hugong (untrained caregivershired by families to be at the bedside of hospitalized indi-viduals). The most significant yet challenging part of thetransformation has been to develop and modify Western-based geriatric models of care (e.g., Acute Care of theElderly unit, delirium prevention and management models,palliative care). Lastly, the department established Tianxia(in the sky) Doctors, an internet-based platform to connectthe department’s interdisciplinary team to other hospitals,nursing institutions, home-based care service stations, com-munity health service centers, and pharmacies throughoutthe region.
