U N I V E R S I T Ä T S M E D I Z I N B E R L I N
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1 U N I V E R S I T Ä T S M E D I Z I N B E R L I N
2 Green Health City Nucleus for a Centre of High-Performance Medicine elisabeth.steinhagen-thiessen@charite.de
3 Background Increasing number of elderly people Decreasing number of younger people Medicine: Less acute diseases and More people suffering from chronic diseases Medical progress increases health costs
4 Demographic Dilemma Aging at the bottom Declining Birth rates + Increased Life expectancy Aging at the top Dramatic aging of the global population Double Aging Prof. Dr. Marckmann, Tübingen
5 Causes of death worldwide WHO World Health Report 2008
6 Aims Minimize morbidity in Cardiovascular Diseases Cancer, Lung and Gastrointestinal Cancer Diseases of the Locomotorsystem Dementia Quality of Life
7 The aging of the population will raise fundamental new challenges for healthcare systems. The combination of increasing longevity and cost-intensive progress in medical treatments calls for a careful allocation of ressources. Resulting implications for future health care (megatrends) Prevention Developing new strategies for disease prevention with the help of modern technology. Individualisation Identifying the most suitable intervention for each patient. (high efficiency with reduced costs)
8 Prevention Strategies Primary Prevention Staying healthy Secondary Prevention Diagnosis/ Treatment Tertiary Prevention Preservation,ADL,Qual.of life Health Disease harm of functional Impairment of viscera constraint daily routine
9 MENTAL: MMSE < 20 FUNCTIONAL: LOSS OF MOBILITY BARTHEL-INDEX < 70 SOCIAL: LOSS OF INDEPENDENCE MEDICAL: > 3 DIAGNOSES > 3 PHARMACEUTICAL DRUGS
10 Aging as a multidimensional process Internal and geriatric medicine Sbj. health Need for treatment Psychiatry Level of global functioning Obj. health Functional capacity Risk profile Assessment of morbidity Determinants of morbidity Coping with morbidity Psychology Intelligence and cognitive function Self and personality Social engagement Sociology and social policy Course of life Economic situation and social security Family history Collective ressources and social participation
11 Geriatric Ward Checkup Kardio./Pulmo. Endo./ Sono. X-Ray/ CT MRI Card. Catheter SPECT/ PET Reception Area
12 Administration Technical IT Food supply Sterile Instr./Logistics Geriatric Ward Checkup Laboratory Pharmacy Kardio./Pulmo. Endo./ Sono. X-Ray/ CT MRI Card. Catheter SPECT/ PET Pathology Consultants Med. Products (ENT, Dental, Optical) Reception Area
13 Seniors Residence Administration Technical IT Food supply Sterile Instr./Logistics Geriatric Ward Checkup Laboratory Pharmacy Kardio./Pulmo. Endo./ Sono. X-Ray/ CT MRI Card. Catheter SPECT/ PET Pathology Consultants Med. Products (ENT, Dental, Optical) Prevention-Centre Reception Area
14 Hotel/ Wellness + day care facility for children Academy/ Congress-Centre Seniors Residence Administration Technical IT Food supply Sterile Instr./Logistics Geriatric Ward Checkup Laboratory Pharmacy Kardio./Pulmo. Hospital Endo./ Sono. with all X-Ray/ CT Wards MRI Card. Catheter SPECT/ PET TCM Pathology Consultants Med. Products (ENT, Dental, Optical) Prevention-Centre Sports-Centre Reception Area Shopping-Mall
15 Green Health City Patient flow
16 Patients transferred from other hospitals Patients, locals VIP Reception (Case-Management) Nationwide Patients
17 Patients transferred from other hospitals Patients from Lecheng VIP Reception (Case-Management) Geriatrics/ Acute hospital Seniors Residence Nationwide Patients Check-Up (ambulatory)
18 Patients transferred from other hospitals Seniors Residence VIP Patients from Lecheng Reception (Case-Management) Geriatrics/ Acute hospital Oncology/ Stem cells Nationwide Patients Check-Up (ambulatory)
19 Patients transferred from other hospitals Seniors Residence VIP Patients from Lecheng Reception (Case-Management) Geriatrics/ Acute hospital Oncology/ Stem cells Nationwide Patients Hotel + Wellness Check-Up (ambulatory)
20 Aims Minimize Morbidity in Cardiovascular Diseases Cancer, Lung and Gastrointestinal Cancer Diseases of the Locomotorsystem Dementia Quality of Life
21 Aging: Adaptability and variability 1) Reduction in general adaptability 2) Increase in interindividual variability 3) Age - Time
22 Extra-individual factors (interventions) Main process i.e. pharmacotherapy positive interventions (compensation) negative interventions (over-/under-) Morbidity Impairment internal diagnosis, dementia, depression Functional losses Disability mobility, balance, coordination, hearing, visual acuity, cognitive function Need for assistance Handicap Difficulty managing ADLs and IADLs Cardiovascular risk factors hyperlipoproteinemia Biological risk factors sex Intra-individual factors (ressources) socioeconomic status
23 U N I V E R S I T Ä T S M E D I Z I N B E R L I N
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Mentis Cura November 29 2012 www.mentiscura.com New Facts on Alzheimer s Death rank nr. 2-5 in western countries Fastest growing disease in: Cost Incedence Death rate People with Alzheimer s 2012 36 million