Palapar Leah, Wilkinson-Meyers Laura, Lumley Thomas, Kerse Ngaire
Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
Health Systems Section, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
J Prim Health Care. 2017 Mar;9(1):78-84. doi: 10.1071/HC16039.
INTRODUCTION Information on the processes used by primary care practices to help identify older patients in need of assistance are limited in New Zealand. AIM To describe the processes used to promote early problem detection in older patients in primary care and the practice characteristics associated with the use of these proactive processes. METHODS Sixty practices were randomly selected from all primary care practices in three regions (52% response rate) and surveyed in 2010 to identify characteristics of practices performing the following activities: using assessment tools; auditing the practice; conducting specific clinics; providing home visits; and providing active patient follow-up. Practice level variables were examined. RESULTS Only 4 (7%) of 57 practices did not perform any of the activities. We found the following associations in the many comparisons done: no activities and greater level of deprivation of practice address (p = 0.048); more activities in main urban centres (p = 0.034); more main urban centre practices doing home visits (p = 0.001); less Canterbury practices conducting specific clinics for frail older patients (p = 0.010); and more Capital and Coast practices following-up patients who do not renew their prescriptions (p = 0.019). DISCUSSION There are proactive processes in place in most New Zealand practices interested in a trial about care of older people. Future research should determine whether different types of practices or the activities that they undertake make a difference to older primary care patients' outcomes.
