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<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">IJGPN</journal-id><journal-title-group><journal-title>International Journal of General Practice Nursing</journal-title></journal-title-group><issn>2981-9415</issn><eissn>2981-9423</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/ijgpn.v3iSpecial.13920</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>Discussion on the Transformation Path of Chronic Disease Health Management Model for the Elderly from the Perspective of Evidence-Based Medicine</title><url>https://artdesignp.com/journal/IJGPN/3/0/10.26689/ijgpn.v3iSpecial.13920</url><author>XuGupan,YuanYiyang,XuXiaofeng</author><pub-date pub-type="publication-year"><year>2025</year></pub-date><volume>3</volume><issue>0</issue><history><date date-type="pub"><published-time>2025-12-31</published-time></date></history><abstract>The intensification of global population aging has made the high incidence of chronic diseases among the elderly a major public health challenge. Traditional management models centered on disease treatment have limitations such as high costs, fragmented services, and delayed interventions. This paper compares the differences between China’s “integration of medical care and elderly care” and Australia’s “Aged Care System,” finding that both face common issues such as uneven distribution of service resources, a shortage of professional talent, and insufficient interdepartmental collaboration. Based on the principles of evidence-based medicine, the paper proposes a systematic transformation path from four aspects: building an early intervention system with prevention as the priority, integrating resources to improve collaborative management mechanisms, empowering management efficiency through technology, and strengthening policy guarantees to promote transformation. It also analyzes the applications and development directions of wearable devices, AI risk assessment, and smart health management platforms. 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