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[为老年人寻求充足医疗保健:文献综述及疾病早期检测与预测工具的应用]

[The quest for adequate health care for the elderly: literature review and the application of an instrument for early detection and prediction of diseases].

作者信息

Veras Renato

机构信息

Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 20559-900, Brasil.

出版信息

Cad Saude Publica. 2003 May-Jun;19(3):705-15. doi: 10.1590/s0102-311x2003000300003. Epub 2003 Jun 11.

Abstract

The increase in the elderly population demands changes in health care models by policymakers to deal with the substantial cost increase This article addresses patient access flow and the definition of priorities in an outpatient unit. A short questionnaire (8 questions) was used to assess enrollment and ranking of the elderly at risk of repeated hospital admissions, considered as a proxy for frailty. In a sample of 360 individuals, 75.8% of the elderly population was classified as "low risk". However, approximately 11% of the sample was considered to be at "medium" or "high" risk of becoming ill and requiring intensive use of health services. Our findings corroborate the usefulness (for promoting an effective health system for the elderly) of the proposed questionnaire as a tool to classify the elderly in different "frailty groups", using a hierarchic definition of vulnerability. The proposed ranking procedure can help adjust the portal of entry into the system, as used thus far in most Brazilian health facilities. The article concludes by suggesting that the validity of the method be tested in a prospective study.

摘要

老年人口的增加要求政策制定者改变医疗保健模式,以应对大幅增加的成本。本文探讨了门诊科室的患者就诊流程和优先事项的定义。一份简短的问卷(8个问题)被用于评估有再次住院风险的老年人的登记情况和排名,这被视为虚弱的一个指标。在360名个体的样本中,75.8%的老年人口被归类为“低风险”。然而,大约11%的样本被认为处于生病并需要大量使用医疗服务的“中等”或“高”风险。我们的研究结果证实了所提议的问卷作为一种工具的有用性(用于促进针对老年人的有效卫生系统),该工具通过对脆弱性的分层定义将老年人分类到不同的“虚弱组”。所提议的排名程序有助于调整进入系统的入口,这是目前大多数巴西医疗机构所采用的方式。文章最后建议在一项前瞻性研究中测试该方法的有效性。

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