Managing the Needs of Older Patients with Multimorbidity—A Systematic Review of the Challenges Faced by the Healthcare Services
Managing the Needs of Older Patients with Multimorbidity—A Systematic Review of the Challenges Faced by the Healthcare Services作者机构：Department of Health Science Stord/Haugesund University College Stord Norway Centre for Women’s Family and Child Health Faculty of Health Sciences University College of Southeast Norway Kongsberg Norway
出 版 物：《Open Journal of Nursing》 (护理学期刊（英文）)
年 卷 期：2016年第6卷第10期
页 面：881-901页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Healthcare Services Multimorbidity Older Patients Systematic Review Thematic Synthesis
摘 要：Research fails to provide an overview of the challenges involved in caring for older patients with multimorbidity. Multimorbidity is defined as the presence of two or more chronic conditions in the same person, leading to a high risk of care dependency. The aim of this review was to illuminate the challenges faced by the healthcare services in managing the needs of older patients with multimorbidity. A systematic review was performed, a total of 1,965 abstracts were read and nine quantitative studies included. Data were analysed by thematic synthesis, revealing six themes: A frequent problem in older female patients;High healthcare expenditure and costs, Medication management problems, Social inequities, Complex healthcare and consultation needs and High mortality. The study highlights that healthcare professionals struggle to obtain suitable guidelines for the care of patients with multimorbidity while trying to respond to their needs. Patient-centred integration across settings and coordination in clinical practice are necessary. The healthcare system today does not seem to focus on patient safety and preventing harm. Older patients should be reviewed by a healthcare professional responsible for coordinating their care. To ensure safe and effective care for elderly persons with multimorbidity, the healthcare services should abandon the current focus on managing innumerable individual diseases and conditions.
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