Kronik Hastalıkları Bulunan Yaşlıların Acil Servis Başvuruları: Entegre Bakım ve Disiplinler Arasında Entegrasyonun Önemi
Özet
Küresel demografik değişimler nedeniyle yaşlı nüfusu ve kronik hastalık yükü hızla artmaktadır. Bu durum yaşlı bireylerin tıbbi ve sosyal bakım ihtiyaçlarını artırarak acil servis (AS) başvurularının sıklaşmasına yol açmaktadır. Genellikle kardiyak ve solunum sistemi hastalıkları ön planda olmakla birlikte, acil servisler akut durumlar dışındaki uzun dönem geriatrik bakım beklentilerini tek başına karşılamakta zorlanmaktadır. Bu süreçte hastaların yaşam kalitesini artırmak amacıyla, birinci, ikinci ve üçüncü basamak sağlık hizmetleri ile sosyal destek hizmetlerini birleştiren "entegre bakım" modellerine ihtiyaç duyulmaktadır. Aile hekimleri, ev temelli sağlık ziyaretleri ve alternatif bakım şekilleriyle bu entegrasyonda kilit bir role sahiptir. Ayrıca acil servislerde proaktif organizasyon modelleri ve yaşlı dostu bakım geçiş alanlarının oluşturulması, hastaların palyatif bakım veya sosyal destek ihtiyaçlarının hızlıca belirlenmesini sağlar. Sorunların çözümü için acil tıp uzmanları, diğer branşlar ve sosyal hizmet uzmanlarının yer aldığı, vaka yöneticisi liderliğindeki multidisipliner ekiplerin iş birliği yapması ve disiplinler arası bakım toplantıları düzenlenmesi kritik öneme sahiptir. Sonuç olarak teknoloji ve bilişim ağıyla desteklenen çok sektörlü uygulamaların geliştirilmesi, acil servislerde zamanı etkin kullanmayı sağlayacak ve yaşlıların bakım sonuçlarını iyileştirecektir.
Due to global demographic shifts, the elderly population and the burden of chronic diseases are rapidly increasing, leading to more frequent emergency department (ED) visits to meet rising medical and social care needs. While cardiac and respiratory diseases are predominantly at the forefront, EDs face difficulties in addressing comprehensive long-term geriatric care expectations during acute traffic. To improve patients' quality of life, there is a vital need for "integrated care" models that combine primary, secondary, and tertiary care levels with social support services, where family physicians play a key role through home-based health visits. Establishing proactive organizational models and elder-friendly care transition areas within EDs facilitates the rapid identification of palliative care or social support requirements. Resolving these complex issues requires effective interprofessional teamwork among ED specialists, other clinical consultants, and social workers within a multidisciplinary team led by a case manager, supported by regular care meetings. Consequently, developing multi-sectoral applications enhanced by technology and information networks will optimize time management in EDs and significantly improve care outcomes for the elderly.
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