Key elements of high-quality primary care for vulnerable elders.
With the impending surge in the number of older adults, primary care clinicians will increasingly need to manage the care of vulnerable elders. Caring for vulnerable elders is complex because of their wide range of health goals and the interdependence of medical care and community supports needed to achieve those goals. In this article, we identify ways a primary care practice can reorganize to improve the care of vulnerable elders. We begin by identifying important outcomes for vulnerable elders and three key processes of care (communication, developing a personal care plan for each patient, and care coordination) needed to achieve these outcomes. We then describe two delivery models of primary care for vulnerable elders--co-management, and augmented primary care. Finally, we discuss how the physical plant, people, workflow management, and community linkages in a primary care practice can be restructured to better serve these patients.
VA Greater Los Angeles Healthcare System 11G, Los Angeles, CA 90073, USA. dganz@mednet.ucla.edu
David A
DA
Ganz
Constance H
CH
Fung
Christine A
CA
Sinsky
Shinyi
S
Wu
David B
DB
Reuben
D000367:Age Factors; D000368:Aged; D006801:Humans; D011320:Primary Health Care / Q000379:methods* / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care / Q000592:standards* / Q000639:trends; D012307:Risk Factors; D035862:Vulnerable Populations