General practitioner-led multidisciplinary team model in management of elderly comorbidity patients in community
10.3760/cma.j.issn.1671-7368.2019.08.022
- VernacularTitle:全科医生主导的多学科团队服务模式管理老年人共病的实践与思考
- Author:
Hui WANG
1
;
Fuying ZHAO
;
Yue JIANG
Author Information
1. 北京市朝阳区高碑店社区卫生服务中心全科医学科 100124
- Keywords:
Comorbidity;
Aged;
General practitioner;
Interdisciplinary team
- From:
Chinese Journal of General Practitioners
2019;18(8):798-800
- CountryChina
- Language:Chinese
-
Abstract:
Patients with multiple diseases have a variety of medical needs,especially in elderly patients with senile syndrome.The conventional specialty care model is not suitable for patients with comorbidities and multidisciplinary intervention and management are required.The article introduces the concept and practice of a general practitioner (GP)-led multidisciplinary team in management of comorbidities in the community.Using one case of elderly patient with multiple diseases as example,the article shows how this model worked and how the patient benefited,and the related issues and reflections are also discussed in the article.
