Abstract:
Older adults constitute a large proportion of patients undergoing surgery and present with complexity, predisposing them to adverse postoperative outcomes. Inequalities exist in the provision of surgical care across the United Kingdom evidenced by increased waiting times in areas of social deprivation, a disparity in the provision of surgical care across geographic locations as well as a variation in the medical management of comorbidities in surgical patients. Addressing inequalities in the delivery of perioperative care for older adults necessitates a multi-faceted approach. It requires implementation of an evidence-based approach to optimisation of older surgical adults using Comprehensive Geriatric Assessment and optimisation methodology at scale, development of an age-attuned, flexible, transdisciplinary workforce, a restructuring of funding to commission services addressing the needs of the older surgical population and a change in culture and professional and public understanding of the needs of the older surgical patient.
摘要:
老年人在接受手术的患者中占很大比例,并且具有复杂性,使他们有不良的术后结局。整个英国在提供外科护理方面存在不平等,这证明了社会贫困地区等待时间的增加,不同地理位置提供手术护理的差异以及手术患者合并症的医疗管理差异。解决老年人围手术期护理中的不平等问题需要采取多方面的方法。它需要实施基于证据的方法,使用全面的老年评估和大规模优化方法来优化老年手术成人,年龄协调的发展,灵活,跨学科劳动力,调整资金,以满足老年手术患者的需求,改变文化以及专业和公众对老年手术患者需求的理解。