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位置: eLearning Site of APLCGG > e-Learning > Oct 22-28, 2012,Geriatrics Fellowship Teaching Schedule > Epidemiology and background

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by aplcgg, 2012-11-12 19:08, 人氣(1151)

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1. Orthogeriatrics and Hip Fracture Antony JohansenConsultant Physician and Orthogeriatrician University Hospital of Wales, Cardiff Honorary Senior Lecturer in Public Health Swansea University

2. The National Health Service in the UKIntroduced by the socialist government after WW2Free health care for all – regardless of age or incomeFunded from general taxation – not health insuranceFamily doctors (GPs) provide front line care in clinicsHospital presentation is by referral, or as ‘emergency’Inpatient medical care – by internists and geriatriciansOther specialists are responsible for their own patientsNo ‘rehabilitation’ specialists – geriatricians lead on thisFinancially constrained, and cost-effectiveness driven

3. Health Services in TaiwanIntroduced … ?Free health care for all … ?Funded from mandatory health insurance … ?Family physicians are clinic and hospital based … ?Initial presentation is often to the Emergency Room … ?Inpatient care generally provided by specialists … ?Specialists are responsible for the whole patient stay … ?Rehabilitation specialists … ?Financially … ?

4. The public health impact of falls and fractures in older peopleAntony Johansen

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10. Emergency Unit attendance with falls – over 75 year olds

11. Over 5% of older people present with a fall each year 5% of people who fall need hospital admissionFalls contribute to 40% of all care home admissions Guideline for the prevention of falls in older people. AGS, BGS, and AAOS panel on falls prevention. JAGS 2001;49:664-72

12. A third of >65 year olds presenting to the A&E department after a fall are admitted:- mean length of stay (LOS) 26 days- mean cost of £5,793Half of those sent home show increased dependencyPrevention of falls in the elderly trial (PROFET); a randomised controlled trial. Close et al. Lancet 1999; 353: 93-97

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