ABSTRACT
El síndrome febril en la persona de edad avanzadarespecto al adulto joven tiene una expresión clinica,una prevalencia de causas específicas y un abordajediagnóstico, que requieren una evaluacióndiferencial. La importancia de este síndrome seincrementa, además, con el aumento de la edad denuestra población, y debe ser considerada en estospacientes siempre como un síntoma de alarma. Encuanto a la etiologia, la arteritis de células giganteses la causa más frecuente de fiebre prolongada sinfoco evidente, seguida según ambienteepidemiológico de la tuberculosis y de lasneoplasias hematológicas. No hay consenso sobre elabordaje diagnóstico, pero es imprescindibleconsiderar el principio de no maleficiencia, debido almayor riesgo de complicaciones asociadas a laspruebas invasivas y a la menor tolerancia a éstas
Fever in the elderly as compared with young adultshas a clinical expression, prevalence, and diagnosisthat require a specific type of evaluation. Thesignificance of fever in the elderly gains importancewith the increase of the populations age and it mustbe considered an alarm signal in these patients.Etiologically, the primary cause of prolonged feverwith unspecific origin in this population, is arteritisof giant cells, followed by (according toepidemiological environment) tuberculosis andhematological neoplasias. There is no consensus ondiagnostic approaches, but it is essential to takegreat care in the process due to risk associated withinvasive tests and low tolerance to them
Subject(s)
Humans , Male , Female , Aged , Fever/etiology , Fever of Unknown Origin/epidemiology , Giant Cell Arteritis/epidemiology , Diagnosis, Differential , Tuberculosis/epidemiology , Hematologic Neoplasms/epidemiology , Infections/diagnosis , Autoimmune Diseases/diagnosisABSTRACT
Fever in the elderly as compared with young adults has a clinical expression, prevalence, and diagnosis that require a specific type of evaluation. The significance of fever in the elderly gains importance with the increase of the population's age and it must be considered an alarm signal in these patients. Etiologically, the primary cause of prolonged fever with unspecific origin in this population, is arteritis of giant cells, followed by (according to epidemiological environment) tuberculosis and hematological neoplasias. There is no consensus on diagnostic approaches, but it is essential to take great care in the process due to risk associated with invasive tests and low tolerance to them.
Subject(s)
Fever/epidemiology , Fever/etiology , Aged , Body Temperature , Humans , Middle AgedABSTRACT
The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike.
Subject(s)
Continuity of Patient Care , Hospitals , Primary Health Care , Continuity of Patient Care/organization & administration , Humans , Models, Organizational , Program EvaluationABSTRACT
Los pacientes atendidos en nuestro sistema sanitario tienen cada vez más edad y mayor prevalencia de enfermedades crónicas. Estas características de salud han condicionado que entre las expectativas de mayor relevancia de los pacientes, se indiquen la accesibilidad al sistema y la continuidad en los cuidados. La colaboración entre los distintos niveles asistenciales ha sido una herramienta reconocida que facilita la consecución de estas expectativas, provocando cambios en la organización del trabajo. Nuestro hospital ha desarrollado un modelo de atención sanitaria que en su orientación al enfermo facilita la colaboración entre los distintos niveles asistenciales, consiguiendo un grado de satisfacción de los profesionales elevado. En este trabajo se describe detalladamente parte del modelo, mostrando los elementos que lo caracterizan, indicando algunos parámetros de la evaluación de resultados y revisando la situación de los modelos de continuidad asistencial publicados. En resumen, consideramos que este sistema asistencial está dotado de elementos de gestión que permiten atender las expectativas de los usuarios, aportando beneficios para el paciente, el profesional y el sistema sanitario (AU)
The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike (AU)
