Characteristics of multiple-diseased elderly in Swedish hospital care and clinical guidelines

International Journal of Ageing and Later Life

Niklas Ekerstad¹  Per Carlsson²  Annika Edberg³ 

[1] The Centre for Medical Technology Assessment/IMH, LinköThe National Board of Health and Welfare, 10630 Stockholm, Sweden;ping University , Sweden;

关键词: Priority setting;    evidence-based guidelines;    elderly;    comorbidity;    cardiovascular disease;    ageism;   

DOI  :  10.3384/ijal.1652-8670.083271

来源: DOAJ

【 摘 要 】

In Sweden, an expected growing gap between available resources and greater potential for medical treatment has brought evidence-based guidelines and priority setting into focus. There are problems, however, in areas where the evidence base is weak and underlying ethical values are controversial. Based on a specified definition of multiple-diseased elderly patients, the aims of this study are: (i) to describe and quantify inpatient care utilisation and patient characteristics, particularly regarding cardiovascular disease and co-morbidity; and (ii) to question the applicability of evidence-based guidelines for these patients with regard to the reported characteristics (i.e. age and co-morbidity), and to suggest some possible strategies in order to tackle the described problem and the probable presence of ageism. We used data from three sources: (a) a literature review, (b) a register study, based on a unique population-based register of inpatient care in Sweden, and (c) a national cost per patient database. The results show that elderly patients with multiple co-morbidities constitute a large and growing population in Swedish inpatient hospital care. They have multiple and complex needs and a large majority have a cardiovascular disease. There is a relationship between reported characteristics, i.e. age and co-morbidity, and limited applicability of evidence-based guidelines, and this can cause an under-use as well as an over-use of medical interventions. As future clinical studies will be rare due to methodological and financial factors, we consider it necessary to condense existing practical-clinical experiences of individual experts into consensus-based guidelines concerning elderly with multi-morbidity. In such priority setting, it will be important to consider co-morbidity and different degrees of frailty

【 授权许可】

Unknown