Archive - April, 2013

Community-based healthcare design for the elderly through “field medicine”

Doctors in hospitals used to think in terms of diseases and conditions in his/her specialty and have little latitude to consider other issues. However, greater emphasis for the need for holistic medical care has increased. This represents the beginning of a transformation in the healthcare system and the evolvement of delivering a healthcare design that moves from a focus on disease care to one on maintaining health and wellness especially for the elderly.

My aim here is to discuss that the community-based healthcare design in providing field medicine is an emerging and promising concept, which addresses healthcare challenges faced in particular by the rural area in Japan.


For the future of healthcare design, look beyond the hospital

The framework of the delivery of health services differs fundamentally in the community as opposed to the hospital setting. In the hospital, the doctors lack the opportunity to invest time and effort in enquiring more about their patients’ lives and understanding the patients’ regular life routines. However in the community, the concept of field medicine (providing healthcare services outside of a hospital) is introduced particularly to the community-dwelling elderly where chronic illnesses become more prevalent. The need to integrate efforts to develop and implement both unique tools and strategies to manage quality in community-based health services is increasing. Geriatricians are also increasingly listening to the voices of the elderly as an integral consideration in the design of a community-based health design policy that bridges both the health of the elderly and the physical environment they reside in.

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Community-based health and aged care in China

The population of China is currently 1.34 billion, which represents almost one-fifth of the world’s population. Over the period 2010 to 2065, it is estimated the proportion of people aged 65 years and over will increase from nine percent to 30 percent. In order to improve equity and financial sustainability, China is undergoing rapid health and aged care system reforms in response to its ageing population and rapid increases in the number of people with chronic diseases.


Innovative programme

Health system reforms include establishing a stronger primary healthcare system that incorporates patient-centred care and chronic disease self-management principles. A recent innovative programme has been introduced in Beijing, China, to help older people with diabetes to manage their illness. Called the “Happy Life Club”, it utilises health coaches trained in behavioural change and counselling principles to address the management of diabetes in older people in primary care settings in China. These coaches support participants to improve modifiable risk factors and adhere to effective self-management treatments associated with diabetes. This type of approach is popular with both health practitioners and older people.

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