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目的构建老年整合门诊,分析老年整合门诊患者特点,了解老年患者需求,为探索、建立和推广适合中国国情的多学科整合门诊提供参考和建议。方法总结多学科整合门诊的具体流程及老年评估的内容,包括对2013—2014年北京协和医院老年整合门诊的患者情况进行统计分析。结果就诊老年患者102例,65岁以上98例(96.0%),平均年龄(74.5±6.3)岁,患有3种以上慢性疾病的患者占52%,存在3种以上老年综合征的患者占63%,多重用药的患者占80.4%,有营养不良及营养不良风险的患者占35.3%;经多学科整合门诊的干预,继续普通老年综合门诊随诊的患者81例,收入老年病房11例,转诊10例。结论多学科团队整合门诊可以有效地处理老年共病患者,发现并干预用药不当、营养不良、抑郁、焦虑等多种老年综合征,是老年患者医疗模式的重要补充。
Objective To construct geriatric integrated clinics, analyze the characteristics of geriatric outpatients, understand the needs of geriatric patients and provide references and suggestions for exploring, establishing and promoting multidisciplinary integrated clinics suitable for China’s national conditions. Methods To summarize the specific process of multidisciplinary integrated clinics and the contents of the elderly assessment, including the statistical analysis of the patients in the elderly integrated clinics of Peking Union Medical College Hospital from 2013 to 2014. Results A total of 102 elderly patients were treated, 98 (96.0%) were over 65 years old, with an average age of 74.5 ± 6.3 years, 52% had three or more chronic diseases, and 63 were older than 3 %, Patients receiving multiple drug use accounted for 80.4%, patients with malnutrition and malnutrition accounted for 35.3%. After intervention by multidisciplinary integrated clinics, 81 patients were followed up for geriatric general outpatients, 11 were admitted to geriatric wards, 10 cases were diagnosed. Conclusion Multidisciplinary teams can effectively treat elderly patients with comorbidity and find and intervene in various types of elderly syndromes such as inappropriate medication, malnutrition, depression and anxiety. It is an important complement to the medical model of elderly patients.