评论
打印
Probably not a surprise to you, but I don't like to be in a hospital or go to a hospital. Do you?
也许你不会惊讶，我不喜欢呆在医院，或去医院看病。你喜欢吗？
I'm sure many of you feel the same way, right?
我相信你们很多人有同样的感受，对吗？
But why? Why is it that we hate hospitals so much?
但为什么？为什么我们如此厌恶医院？
Or is it just a fact of life we have to live with?
这不是生活中不可避免的一个事实吗？
Is it the crappy food? Is it the expensive parking?
是难吃的病号饭？是昂贵的停车费？
Is it the intense smell? Or is it the fear of the unknown?
是强烈的药水气味？或者是对未知的恐惧？
Well, it's all of that, and it's more.
全部都有，而且不止这些。
Patients often have to travel long distances to get to their nearest hospital,
病人常常需要赶很长一段路才能到最近的医院，
and access to hospital care is becoming more and more an issue in rural areas, in the US,
而且在美国的乡村地区要获得医院护理越来越成问题，
but also in sparsely populated countries like Sweden.
在瑞典这样人口稀少的国家也是如此。
And even when hospitals are more abundant, typically the poor and the elderly
即便当医院资源更加充裕时，特别是穷人和老人
have trouble getting care because they lack transportation that is convenient and affordable to them.
也通常因为缺乏便利、廉价的交通而无法获得医疗服务。
And many people are avoiding hospital care altogether, and they miss getting proper treatment due to cost.
许多人甚至完全避开医疗治疗，为了节省开销而错过了合适的治疗。
We see that 64 percent of Americans are avoiding care due to cost.
我们可以看到，有64%的美国人因为费用问题而避免医疗服务。
And even when you do get treatment, hospitals often make us sicker.
即便你接受了治疗，医院也常常会让我们病情加重。
Medical errors are reported to be the third cause of death in the US,
据报道，医疗事故是美国的第三大致死因素，
just behind cancer and heart disease, the third cause of death.
仅次于癌症和心脏疾病的第三大死因。
I'm in health care for over 20 years now, and I witness every day how broken and how obsolete our hospital system is.
我从事医疗行业已经20多年了，每天我都见证着我们的医院系统是如此的破败和落后。
Let me give you two examples. Four in 10 Japanese medical doctors and five in 10 American medical doctors are burnt out.
让我给你们两个例子。10个日本医生中有4个，10个美国医生中有5个已经在超负荷工作了。
In my home country, the Netherlands, only 17 million people live there.
在我的祖国，荷兰，只有1700万人口。
We are short 125,000 nurses over the coming years.
在未来几年，我们会缺少12.5万名护士。
But how did we even end up here, in this idea of placing all kinds of sick people together in one big building?
但我们是怎么走到这一步的，把所有病人都集中到一幢大楼里的？
Well, we have to go back to the Ancient Greeks.
这就要追溯到古希腊时期。
In 400 BC, temples for cure were erected where people could go to get their diagnosis, their treatment and their healing.
公元前400年，人们建造了治病的庙宇，病人在那里可以得到诊断、治疗和恢复。
And then really for about 2,000 years, we've seen religious care centers all the way up to the Industrial Revolution,
在之后的2000年间，我们看到了教会的护理中心，直到进入工业革命时期，
where we've seen hospitals being set up as assembly lines based on the principles of the Industrial Revolution,
我们看到医院基于工业革命的原则，像流水线那样尽快产出产品，
to produce efficiently and get the products, the patients in this case, out of the hospital as soon as possible.
提升了生产效率，在医院的案例中，产品变成了病人，以让他们尽快走出医院。
Over the last century, we've seen lots of interesting innovations.
在过去一个世纪中，我们看到了很多有趣的创新。
We figured out how to make insulin. We invented pacemakers and X-ray,
我们找到了制造胰岛素的方法。我们发明了起搏器和X光，
and we even came into this wonderful new era of cell and gene therapies.
我们甚至进入了细胞和基因治疗的奇妙新时代。
But the biggest change to fix our hospital system altogether is still ahead of us.
但修复我们医疗系统的最大变革仍然没有到来。
And I believe it's time now, we have the opportunity,
我相信现在是时候了，我们有机会
to revolutionize the system altogether and forget about our current hospital system.
去彻底改革整个系统，完全忘掉我们现有的医院系统。
I believe it's time to create a new system that revolves around health care at home.
我相信是时候创造新的，以家庭护理为中心的系统了。
Recent research has shown that 46 percent of hospital care can move to the patient's home. That's a lot.
最近的研究发现，46%的医院治疗可以转移到患者家中进行。这个数量相当庞大。
And that's mainly for those patients who suffer from chronic diseases.
这主要是针对那些患有慢性疾病的病人。
With that, hospitals can and should reduce to smaller, agile and mobile care centers focused on acute care.
对此，医院可以，而且应该精简到专注于急症治疗的更加小型、灵活和移动的医疗中心。
So things like neonatology, intensive care, surgery and imaging will still remain at the hospitals,
比如新生儿，重症监护，手术和成像，这些可以仍然保留在医院，
at least I believe for the foreseeable future.
至少在可预见的未来是这样。
A few weeks ago, I met a colleague whose mom was diagnosed with incurable cancer, and she said,
几周前，我遇到一个同事，她妈妈被诊断患了癌症，时日无多，她说：
"Niels, it's hard. It's so hard when we know that she's got only months to live.
“尼尔斯，真的很艰难。当知道她只有几个月生命时，一切都变得如此艰难。
Instead of playing with the grandchildren,
她无法再和孙子们玩耍了，
she now has to travel three times a week two hours up and down to Amsterdam just to get her treatment and tests."
现在她每周需要外出三次，经历两个小时的颠簸到阿姆斯特丹，就为了进行治疗和检查。”
And that really breaks my heart, because we all know that a professional nurse could draw her blood at home as well, right?
这让我感到很伤心，因为我们都知道，一个专业的护士在家就可以进行抽血操作，对吧？
And if she could get her tests and treatment at home as well,
如果她也能在家接受治疗和检查，
she could do the things that are really important to her in her last months.
就可以利用她生命的最后几个月做一些真正对她重要的事情。
My own mom, 82 years old now -- God bless her
我的母亲，现在82岁了--老天保佑她，
she's avoiding to go to the hospital because she finds it difficult to plan and manage the journey.
她不想去医院，因为她发现很难规划和管理她的行程。
So my sisters and I, we help her out.
于是我和妹妹会帮她搞定。
But there's many elderly people who are avoiding care and are waiting that long that it becomes life-threatening,
但有很多不去医院的老年人，拖的时间过长，到了危及生命的程度，
and it's straight to the costly, intensive care.
不得不直接进入昂贵的重症监护环节。
Dr. Covinsky, a clinical researcher at the University of California,
科文斯基博士，加州大学的临床研究员，
he concludes that a third of patients over 70 and more than half of patients over 85,
得出结论，1/3年龄超过70岁的人和超过一半年龄超过85岁的人，
leave the hospital more disabled than when they came in.
离开医院时比他们进来的时候更糟糕。
And a very practical problem that many patients face when they have to go to a hospital is:
很多病人去医院不得不面临的一个实际问题是：
Where do I go with my main companion in life, where do I go with my dog?
我和我的主要生活伴侣要去哪里，我和我的狗要去哪里？
That's our dog, by the way. Isn't she cute?
这是我的狗。她是不是很可爱？
But it's not only about convenience. It's also about unnecessary health care stays and costs.
但这并不只跟便利有关。它还涉及到不必要的医疗住宿和费用。
A friend of mine, Art, he recently needed to be hospitalized for just a minor surgery,
我的一个朋友，阿特，他最近需要住院接受一个小手术，
and he had to stay in the hospital for over two weeks, just because he needed a specific kind of IV antibiotics.
他不得不在医院呆两个星期，只是因为他需要一种特殊的静脉抗生素。
So he occupied a bed for two weeks that cost over a thousand euros a day. It's just ridiculous.
于是他占用了一张病床两周，每天需要花费超过1千欧。这真是荒谬。
And these costs are really at the heart of the issue.
这些费用正是问题的核心。
So we've seen over many of our global economies, health care expense grow as a percentage of GDP over the last years.
我们看到了很多全球经济中，医疗支出在GDP中的占比在过去这些年一直在增长。
So here we see that over the last 50 years,
在过去50年间，
health care expense has grown from about five percent in Germany to about 11 percent now.
医疗费用占比在德国从5%上升到现在的11%。
In the US, we've seen growth from six percent to over 17 percent now.
在美国，这个比例从6%上升到17%。
And a large portion of these costs are driven by investments in large, shiny hospital buildings.
这些花费中很大部分来于对宏伟，熠熠生辉的医院建筑的投资。
And these buildings are not flexible,
这些大楼并不灵活，
and they maintain a system where hospital beds need to be filled for a hospital to run efficiently.
还维持着一个需要让医院的床位被占满，以保持医院效率的体系。
There's no incentive for a hospital to run with less beds.
于是医院就没有动力减少床位。
Just the thought of that makes you sick, right?
一想到这个你就恶心，是吧？
And here's the thing: the cost for treating my buddy Art at home can be up to 10 times cheaper than hospital care.
事实上：我的朋友阿特在家治疗的费用要比医在院的花费便宜10倍。
And that is where we're headed. The hospital bed of the future will be in our own homes.
那就是我们前进的方向。医院未来的床位在我们自己的家中。
And it's already starting. Global home care is growing 10 percent year over year.
而且这种趋势已经开始了。全球家庭护理正在以每年10%的速度增长。
And from my own experience, I see that logistics and technology are making these home health care solutions work.
从我个人的经验来看，物流和技术让家庭医疗护理变得可行。
Technology is already allowing us to do things that were once exclusive to hospitals.
技术让我们可以做过去只有医院才能做的事情。
Diagnosis tests like blood, glucose tests, urine tests, can now be taken in the comfort of our homes.
如血液、葡萄糖和尿液检测那样的诊断测试，现在可以在舒适的家中进行。
And more and more connected devices we see like pacemakers and insulin pumps that will proactively signal if help is needed soon.
越来越多的联网设备，如心脏起搏器和胰岛素泵，在紧急情况下会发出预警信号。
And all that technology is coming together in much more insights into the patients' health,
所有这些技术组合在一起可以更加深入地理解病人的健康，
and that insight and all of the information leads to better control and to less medical errors
这样的剖析和所有这些信息可以带来更好的控制，并减少医疗事故，
remember, the third cause of death in the US.
记住，这可是美国第三大死因。
And I see it every day at work. I work in logistics and for me, home health care works.
我每天都在工作中见证这些。我工作在物流领域，对我而言，家庭医护的确可行。
So we see a delivery driver deliver the medicine to the patient's home.
我们看到送货司机运输药物到患者家中。
A nurse joins him and actually administers the drug at the patient's home.
护士与他一道，在患者家中进行管理药物。
It's that simple. Remember my buddy, Art?
就是这么简单。还记得我的朋友，阿特？
He can now get the IV antibiotics in the comfort of his home:
他现在可以在舒适的家中获得静脉注射抗生素：
no hospital pajamas, no crappy food and no risk of these antibiotic-resistant superbugs that only bite you in these hospitals.
不需要穿病号服，吃难吃的病号餐，也不会面临被只存在于医院中的那些耐抗生素的超级病菌叮咬的风险。
And it goes further. So now the elderly people can get the treatment that they need in the comfort of their own home
好处还不止于此。现在老年人也可以在他们舒适的家中获得所需要的治疗，
while with their best companion in life.
同时有生活中最佳伴侣陪同。
And there's no need anymore to drive hours and hours just to get your treatment and tests.
也不再需要开车几个小时，只是为了获得医疗和检查。
In the Netherlands and in Denmark,
在荷兰和丹麦，
we've seen very good successes in cancer clinics organizing chemotherapies at the patient's homes,
我们在癌症诊所看到了在病人家中组织化疗的非常成功的例子，
sometimes even together with fellow patients.
有时候甚至几个病友一起。
The best improvements for these patients have been improvements in reduction in stress, anxiety disorders and depression.
对于这些病人而言，最大的改善在于压力、焦虑障碍和抑郁的减轻。
Home health care also helped them to get back a sense of normality and freedom in their lives,
家庭医护也帮助他们找回了生活中的正常和自由的感觉，
and they've actually helped them to forget about their disease.
这其实也帮助他们忘记了病痛。
But home health care, Niels -- what if I don't even have a home, when I'm homeless,
但关于家庭医护，尼尔斯--如果我没有家，当我无家可归时，
or when I do have a home but there's no one to take care of me or even open up the door?
或者当我有家，但没人可以照看我，或者连开窗户都没人帮忙时怎么办？
Well, in comes our sharing economy, or, as I like to call it, the Airbnb for home care.
这个时候我们的共享经济就发挥作用了，或者，我喜欢称之为家庭医护爱彼迎。
In the Netherlands, we see churches and care organizations match people in need of care
在荷兰，我们看到教堂和护理机构会将需要护理和陪伴的人们，
and company with people who actually have a home for them and can provide care and company to them.
与有家并能提供医护和陪伴的人们进行匹配。
Home health care is cheaper, it's easier to facilitate, and it's quick to set up -- in these rural areas we talked about,
家庭医护更便宜，它易于安置，可以快速投入使用--在这些我们谈到的农村地区，
but also in humanitarian crisis situations where it's often safer, quicker and cheaper to set things up at home.
也在人道主义危机的情况下，把医疗设施放在家里通常要更加安全、快速和廉价。
Home health care is very applicable in prosperous areas but also very much in underserved communities.
家庭医护非常适用于繁荣地区，但在服务水平低下的社区也是如此。
Home health care works in developed countries as well as in developing countries.
家庭护理对发达国家有效，对发展中国家也是如此。
So I'm passionate to help facilitate improvements in patients' lives due to home health care.
因此，我非常热衷于通过家庭医护服务帮助改善病人的生活。
I'm passionate to help facilitate that the elderly people get the treatment that they need in the comfort of their own homes,
我热衷于帮助那些老年人在自己舒适的家中获得所需要的治疗，
together with their best companion in life.
有他们生活中最佳伴侣的陪伴。
I'm passionate to make the change and help ensure that patients, and not their disease, are in control of their lives.
我热衷于推动改变，帮助确保是病人，而不是他们的疾病在掌控他们的生活。
To me, that is health care delivered at home. Thank you.
对我而言，这就是医疗护理上门服务。谢谢。
