Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 31

Interest in gerontology in the UK was stimulated by the support of charitable foundations and the enthusiasm of a few individuals. The Nuffield Foundation created a medical and biological Research Committee, which gave grants to Howell for his research, to Dr Alex Comfort to work with Sir Peter Medawar at Birmingham and later at University College London, and to Professor Sir Frederick Bartlett at the University of Cambridge to establish a research unit to investigate the psychological aspects of ageing. The Nuffield and Ciba Foundations supported Vladimir Korenchevsky (1880–1959), a Russian biologist who had studied under Pavlov and Metchnikoff. His enthusiasm for the science of ageing culminated in his becoming director of the Oxford Gerontological Institute. He was a driving force behind the creation of the International Association of Gerontology (IAG). The Ciba Foundation supported the IAG, which held its first meeting in 1950 in Liège, Belgium. The first meeting of the clinical section of the IAG was held in Sunderland in the UK in 1958 and was chaired by Dr Oscar Olbrich. A later meeting was held in Manchester in 1974, which was organised by Professor John Brocklehurst. The Ciba Foundation maintained its interest in old age by establishing a series of special colloquia in London, which were attended by many international experts on ageing, and supported the British Society for the Research in Ageing, which was founded by Korenchevsky.

As the new‐style treatment methods were applied to the previously neglected chronic sick, clear evidence emerged of its effectiveness, particularly in hospitals. Official health data sources, such as Hospital In Patient Enquiry (HIPE) data collection, the Office of Health Economics and Health and Personal Social Services Statistics for England, showed that the number of deaths and discharges of elderly people and patient turnover from geriatric wards steadily increased while the average and median lengths of stay decreased. In 1980, the Chief Medical Officer for England and Wales was able to report ‘the average length of stay for patients in hospital departments of geriatric medicine is steadily diminishing – more so than in any other hospital specialty. Only 10% remain in hospital for more than 6 months; the median length of stay is only 21.7 days’.²⁷ Progress was such that in 1984, the Nuffield Provincial Hospital Trust was able to comment, ‘It [geriatric medicine] has established its expertise and has had notable success in developing and raising the standards of services for the old’.²⁸ Concomitant with these developments, individual geriatricians began to create differing styles of practice: whereas some did not take emergency admissions, others took increasing numbers of acutely ill patients, and still others reintegrated with general medicine, taking part in unselected acute medical intake and joint ward rounds with their general physician colleagues.