Providing Better Care for Vulnerable Elders in the Primary Care Setting
With the increasing number of older adults, primary care clinicians will need to manage the care of more vulnerable elders. Of the 37 million Americans older than age 65, about 7.8 million might be classified as vulnerable – elders whose age, health, and/or functional limitations put them at risk for death or functional decline. Caring for vulnerable elders is complex because of their wide range of health issues; moreover, primary care physicians usually provide continuity and coordination of care for this patient population. This article discusses ways in which a primary care practice can reorganize to improve the care of vulnerable elders.
Investigators identify three key processes of care needed to achieve better outcomes for vulnerable elder patients: communication, developing a personal care plan for each patient, and care coordination. They also describe two delivery models of primary care: co-management (e.g., primary care clinician shares patient responsibility with another clinician or care team with additional expertise in caring for vulnerable elders), and augmented primary care (e.g., enhanced decision support for clinicians, such as computerized clinical reminders). Using a case scenario, providing better care for vulnerable elders is demonstrated by optimizing process of care strategies as well as elements important to primary care clinic functioning (e.g., clinic staff, workflow, community links, and physical design/structure of the clinic).
Ganz D, Fung C, Sinsky C, Wu S, and Reuben D. Key elements of high-quality primary care for vulnerable elders. Journal of General Internal Medicine December 2008;23(12):2018-2023.
This study was partly funded by HSR&D. Dr. Ganz was supported by an HSR&D Career Development Award.