Ford John A, Kharicha Kalpa, Clarke Caroline S, Clark Allan, Iliffe Steve, Goodman Claire, Manthorpe Jill, Steel Nick, Walters Kate
Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK.
Department of Primary Care and Population Health, University College London, Royal Free Campus Rowland Hill St, London, NW3 2PF, UK.
BMC Health Serv Res. 2017 Mar 6;17(1):176. doi: 10.1186/s12913-017-2122-6.
Recruiting patients to health promotion programmes who will benefit is crucial to success. A key policy driver for health promotion in older people is to reduce health and social care use. Our aim was to describe service use among older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion programme.
A random sample of 1 in 3 older people (≥65 years old) was invited to participate in the Multi-dimensional Risk Appraisal for Older people project across five general practices in London and Hertfordshire. Data collected included socio-demographic characteristics, well-being and functional ability, lifestyle factors and service use. Latent class analysis (LCA) was used to identify groups based on use of the following: secondary health care, primary health care, community health care, paid care, unpaid care, leisure and local authority resources. Differences in group characteristics were assessed using univariate logistic regression, weighted by probability of class assignation and clustered by GP practice.
Response rate was 34% (526/1550) with 447 participants presenting sufficient data for analysis. LCA using three groups gave the most meaningful interpretation and best model fit. About a third (active well) were fit and active with low service use. Just under a third (high NHS users) had high impairments with high primary, secondary and community health care contact, but low non-health services use. Just over a third (community service users) with high impairments used community health and other services without much hospital use.
Older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion can be described as three groups: active well, high NHS users, and community service users.
招募能从中受益的患者参与健康促进项目是项目成功的关键。促进老年人健康的一项关键政策驱动因素是减少医疗和社会护理的使用。我们的目的是描述参与老年人初级保健健康促进多维风险评估项目的老年人的服务使用情况。
从三分之一的老年人（≥65岁）中随机抽取样本，邀请他们参与伦敦和赫特福德郡五个全科诊所的老年人多维风险评估项目。收集的数据包括社会人口学特征、幸福感和功能能力、生活方式因素以及服务使用情况。潜在类别分析（LCA）用于根据以下服务的使用情况识别不同群体：二级医疗保健、初级医疗保健、社区医疗保健、付费护理、无偿护理、休闲和地方当局资源。使用单因素逻辑回归评估群体特征的差异，按类别分配概率加权，并按全科医生诊所聚类。
回复率为34%（526/1550），447名参与者提供了足够的分析数据。使用三组的潜在类别分析给出了最有意义的解释和最佳的模型拟合。约三分之一（健康活跃组）健康且活跃，服务使用量低。略低于三分之一（国民保健服务高使用组）有高度损伤，初级、二级和社区医疗保健接触率高，但非医疗服务使用量低。略多于三分之一（社区服务使用组）有高度损伤，使用社区医疗和其他服务，但很少住院。
参与老年人初级保健健康促进多维风险评估的老年人可分为三组：健康活跃组、国民保健服务高使用组和社区服务使用组。
