Geriatric Medicine
- section of UEMS
Delegates:
Santiago Cotobal Rodeles
scotobalr@gmail.comJesús Mateos del Nozal
je_mdn@yahoo.esMaria Victoria Farre-Mercade
mavifarre@hotmail.com Spain
Adequacy of Geriatric Resources In Spanish General Hospitals
ABSTRACT
Objective:
To evaluate the adequacy of geriatric resources to meet the needs of elderly individuals hospitalised for acute illness in Spain.
Material and method:
We performed a descriptive, cross-sectional study. General hospitals in Spain with mom than 100 beds on the lot of June, 2003, were included Each hospital was classified as: 1) no provision of specialised geriatric care: no specific geriatric resources or specialised geriatric coverage in the hospital; and 2) provision of specialised geriatric care: geriatric resources and consequently some geriatric coverage. Depending on the type of geriatric resources available, hospitals were also classified as: those providing geriatric evaluation by multidisciplinary functional teams according to different types of regions (incomplete} and those providing more complete geraiatric care (evaluation mad intervention) with acute geriatric care, units. All the data was assessed and corroborated by the presidents or offices of each Spanish Regional Society of Geriatrics and Gerontology. The results were analysed globally and by regions.
Results:
Of 798 hospitals, 216 were general hospitals with more thin 100 beds. In 146 hospitals (68%), there were no specialised geriatric resources for acute stage illness. In 49 hospitals (22%) specialised geriatric care was incomplete and in 21 hospitals (10%) it was more complete. The regions with the widest geriatric coverage were Cetalaaia (77%); Madrid (54%) and Castilla-La Mancha (50%). Cantabria and Pais Vasco had no geriatric converage in acute hospitals, while Asturias, Baleares and Andalucia had very low levels of geriatric coverage (11%, 11% and 9% respectively). The regions with the widest provisions of acute care geriatric units in general hospitals were Madrid (31%) and Castilla-La Mancha (30%}. Seven regions had no hospitals with acute care geriatric units.
Conclusions:
Currently most general hospitals in Span do not have adequate provision of specialised geriatric care and the distribution of the geriatric resources among the different regions is uneven.
Definición de Medicina geriátrica (aceptada en Malta el 3/5/2008, y mejorada en Copenhaguen el 6/09/2008)
La geriatría es una especialidad médica que atiende la problemática física, mental, funcional y social tanto en la fase aguda, como crónica, de rehabilitación, preventiva y de final de vida de los pacientes ancianos.
Estos pacientes se caracterizan por poseer un alto grado de fragilidad y de pluripatología activa, por lo que precisan de un abordaje holístico. La presentación de las enfermedades es distinta en la edad avanzada y a menudo son difíciles de diagnosticar; por lo que la respuesta al tratamiento suele retrasarse y frecuentemente se necesita un soporte social.
De este modo, la geriatría va más allá de la medicina centrada en el órgano; por lo que requiere de un abordaje multidisciplinar que tiene como principal objetivo, optimizar el estado funcional de la persona anciana y mejorar su calidad de vida así como su autonomía.
La geriatría no se define específicamente por la edad, sino que también considera la morbilidad típica que presentan los pacientes ancianos. La mayoría de pacientes serán mayores de 65 años, pero los problemas mejor tratados por la especialidad de geriatría son más frecuentes en el grupo de pacientes mayores de 80 años.
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Se reconoce que, por razones históricas y estructurales, la organización de la medicina geriátrica puede variar entre los distintos países miembros europeos.