With the acceleration of population aging, the health problems and care service needs of the elderly are increasing, while the capacity for family-based care is declining. To address these challenges, China has proposed the "integrated medical and nursing care" service model, which integrates medical and health services with elderly care. Geriatric medicine is one of the key technical components of this integrated service model. This study aims to construct a technical standard system for geriatric medicine within the integrated medical and elderly care services. It mainly includes the basic principles, overall framework, structure, and explanations of the geriatric medicine technical standard system, providing a technical and directional framework for the geriatric medicine technical standard system in the context of integrated medical and elderly care services.
ObjectiveTo develop a risk prediction scale for 6-month mortality in elderly patients with advanced chronic obstructive pulmonary disease (COPD), and provide a theoretical basis for creating tools to predict survival in this patient population. Methods A literature review was conducted to identify and extract risk factors associated with 6-month mortality in elderly patients with advanced COPD, forming the initial item pool for the scale. A Delphi method was employed, involving two rounds of correspondence with 17 multidisciplinary experts through a designed questionnaire. Items were comprehensively screened based on the arithmetic mean of item importance, coefficient of variation, and full score frequency to determine the final scale. ResultsThe effective response rates for the two rounds of expert correspondence were 94.12% and 100.00%, respectively. The expert authority coefficients were both ≥0.90 (0.93 and 0.90, respectively). The Kendall's coefficients of concordance were 0.28 and 0.26 (both P<0.05), indicating good coordination and authority among the experts and reliable results from the correspondence. The final constructed risk prediction scale for short-term mortality in elderly patients with advanced COPD includes 10 primary items and 55 secondary items. The 10 primary items are as follows: demographic characteristics, prognostic prediction, disease course, complications, comorbidity status, geriatric syndromes, signs/symptoms, COPD symptom scores, examination/laboratory indicators, and COPD treatment. ConclusionsThe Delphi-based risk prediction scale for 6-month mortality in elderly patients with advanced COPD is reliable and objective, and is expected to be a valuable tool to predict survival in this patient population.
