Organization of Health Care Services for the Elderly: Russia

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Organization of Health Care Services for the
Elderly Russia

• A.M.Clarfield MD, FRCPC
• Professor of Gerontology
• Ben Gurion University,
• Israel

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The typical geriatric patient

• chronic disease
• multiple disease (co-morbidity)
• multiple drugs (polypharmacy)
• social isolation and poverty
• ? physiological function
• LOSS OF RESERVE

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An Approach

• Caveat

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An Approach

• education
• health promotion
• prevention
• strengthen primary care
• acute care
• rehabilitation
• home
• long-term care
• institution

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Education

• medical school
• - preclinical
• - clinical
• residency primary care
• - internal medicine
• - others (eg. urology, orthopedics)
• CME

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Premature

• mortality in the elderly
• IHD
• CVA
• Influenza (grippe )
• morbidity in the elderly
• Osteoporosis
• Fractures
• Influenza (grippe )

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Smoking in Russia (1993)

• 67 of men!
• 30 of women
• Increase in children

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Accelerated aging
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Health Promotion (examples)

• Smoking in middle age
• Exercise
  (Timur Shaov)

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Prevention (primary and secondary)

• Osteoporosis (Calcium)
• Influenza vaccine

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Prevention (primary and secondary)

• Cholesterol (gt250 mg- 20 of population)
• treatment of hypertension
• ( Russia gt140/90 60 men,
• 25 women)
• polypill
• (Wald and Law, BMJ, 2003)

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Strengthen Primary Care
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Rehabilitation

• post CVA - hospital
• - home
• post hip fracture hospital
• Yad Sarah

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Long-term care (20 of 65)

• home care ( 15) preferred
• institutional ( 5)

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What is to be done? (next)
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An Approach

• education
• health promotion
• prevention
• strengthen primary care
• acute care
• rehabilitation
• home
• long-term care
• institution

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• Thank You
• ???????
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