ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04146.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04147.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04148.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04149.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04150.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04151.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Elderly people, particularly those over age 75, are subject to problems of access to needed health services, of the appropriateness of these services in relation to their needs, and of increasing infirmity, disability and dependency, with loss of their natural support systems. The proportion of health expenditures deployed to deal with the institutionalization and long‐term requirements of elderly people is increasing in a national climate characterized by tightening constraints on public expenditures for health care under Medicare and Medicaid. The Robert Wood Johnson Foundation has accepted objectives and roles to find better ways to use what we already know to improve elderly people's access to health care, to improve their functional effectiveness, and to make their health care more affordable. The results of some of the programs it has supported represent innovative approaches and demonstrate ways in which we may accomplish these objective

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04152.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Previously reported large autopsy series have indicated that elderly patients who die of cancer are less likely to have metastatic disease than their younger counterparts. This observation could be explained if survival were shorter in the elderly population and patients died with smaller tumor burdens. The authors analyzed Medical Center Hospital of Vermont (MCHV) Tumor Registry data on primary lung cancer with respect to age. As in the reported autopsy series, at the time of diagnosis elderly patients were less likely to have metastatic disease. Further analysis was undertaken of the patients from this series who died and were autopsied at MCHV. Although the total numbers were small, survival was not shorter in the advanced age groups. The authors suggest that elderly patients have slower tumor growth and less metastatic disease, not because of earlier diagnosis and shorter survival, but because of senescent host factors that impede aggressive tumor growth and spread.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04153.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Biliary sepsis, appendicitis, diverticulitis, and intraabdominal abscess are intraabdominal infections that are especially relevant to the elderly population. Diagnostic delays, reluctance to perform surgery, presence of underlying disease, and postoperative complications contribute to the higher morbidity and mortality rates seen for elderly patients with these infections.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04154.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Responding to a perceived need for specialized care for the acutely ill elderly, a 14‐bed geriatric special‐care unit was established in the University of Massachusetts Hospital in January 1980. Patients were selected for admission after assessment of their potential to benefit from restorative care. Most patients were admitted from the emergency room or outpatient clinics or were scheduled admissions; a few were in‐hospital transfers. This report deals with a retrospective analysis of the first 514 admissions (431 patients) to the unit. Admissions by major service were: Medicine, 64 per cent; Surgery, 14 per cent; Neurology, 10 per cent; Orthopedics, 7 per cent; and other, 5 per cent. Approximately 64 per cent of patients were between the ages of 70 and 84. The overall average length of stay per admission was 11.5 days. Mortality rate of patients undergoing surgery (n= 125) was 4 per cent. The percentage of admissions that were discharged home was 78.7 per cent. Only 7.3 per cent of admissions were discharged to a nursing home, when those that were admitted to the unit from a nursing home are excluded. The authors conclude that a special nursing unit for acutely ill elderly patients may serve several purposes in a university hospital: overall patient care may be improved; length of hospital stay may be shortened; and medical students, housestaff, and attending physicians may gain an opportunity to learn the fundamentals of geriatric medicine as demonstrated by the staff of the

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04155.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY