The integration of chronic care and emergency medicine
نویسنده
چکیده
The paradigm of Emergency Medicine (EM) is to provide the right care at the right time in the right place by the right professionals. This requires a combination of key service elements to be brought together, including triage, resuscitation, mobile response units (ambulances, trauma helicopters, blue lights) and out of duty services. In Holland, integration of Emergency Medicine has been emphasised, for example between general practitioners out of duty services, emergency departments, ambulance services, emergency home care for serious ill patients at home and acute psychiatric services. Such integration, however, fails to appreciate the root causes of demand for emergency care—particularly the fact that today the majority of patients treated in emergency settings (and particularly those who have multiple emergency admissions) are the result of an acute episode related to one or more pre-existing chronic illnesses. Unlike integrated care for Emergency Medicine, the paradigm for treating chronic care patients—as formulated by Wagner w1x and Kaiser Permanente professionals w2x—stress self-management, health education, case management, and feedback systems for professionals based on modern health information technology. This form of integration is focused on primary care and hospital care, health care and social care, informal and formal care.
منابع مشابه
Achieving Integrated Care for Older People: What Kind of Ship?; Comment on “Achieving Integrated Care for Older People: Shuffling the Deckchairs or Making the System Watertight for the Future?”
This paper considers an implication of the idea that proposals for integrated care for older people should start from a focus on the patient, consider co-production solutions to the problems of care fragmentation, and be at a system-wide, cross-organisational level. It follows that the analysis, design and therefore evaluation of integrated care projects should be based upon the journeys which ...
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