Articles: ninos.
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Hospital admission is a significant event in the healthcare trajectory of older adults (age 60 +). Numerous harms such as delirium, falls, and adverse medication events can arise that outweigh the benefits of admission. Little is known about how older adults feel about being hospitalized or what they think admission will achieve for them. These issues are particularly important to understand in socioeconomically disadvantaged patients, who have poor access to outpatient care and higher hospitalization rates. ⋯ Older adults' expectations of hospitalization exceed stabilization of acute illness. Hospital admission of older adults presents an opportunity for shared decision-making and communication about likely outcomes of hospitalization. Incorporating patient-centered outcomes into admission decisions may help align care with older adults' priorities in the ED.
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The USA has some of the highest costs of medical care in the world. Telemedicine has been proposed as an affordable alternative to traditional in-person care, increasing access to medical services. ⋯ This viewpoint discusses the equity implications of the expansion of direct-to-consumer telemedicine-only medical care or care, which takes place entirely in the virtual realm, often with no requirement for a previous patient-provider relationship. We propose an approach to digital health that looks beyond digital literacy and access to technology to consider systemic challenges to equitable implementation.