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从澳大利亚老年人健康评估中可以学到什么?

What is learned from an Australian older person health assessment?

机构信息

School of Rural Health, Monash University, Bairnsdale, Vic. 3875, Australia. Email:

Dr Jane's Plane, Cunninghame Arm Medical Centre,188 Macleod Street, Bairnsdale, Vic. 3875, Australia. Email:

出版信息

Aust Health Rev. 2021 Aug;45(4):491-496. doi: 10.1071/AH20064.

Abstract

Objective To examine what new health information is identified at a patient's most recent 75+HA compared with their standard GP consultations in the prior 24 months. Methods Parameters measured included newly identified chronic conditions, new management for previously diagnosed chronic conditions, medication management, referrals, vaccinations, and positive test results for the monitoring of previously diagnosed chronic conditions. A retrospective patient record study collecting data from two GP clinics in metropolitan and regional Victoria was undertaken. A total of 195 75+HA recipients were included. Results No significant difference was found in the number of new chronic conditions recorded at patients' most recent 75+HA compared with standard GP consultations in the prior 24 months. However, significant differences in the types of conditions were noted, with 75+HAs significantly more likely to record elevated lipids (P<0.001), vitamin D deficiencies (P=0.004), eye/vision-related (P=0.011), diabetes (P=0.019), and hearing conditions (P=0.045) compared with standard GP consultations. Significantly more referrals (P<0.001) and new management for previously diagnosed conditions (P=0.009) occurred at 75+HA than at standard GP consultations. Patients who were receiving their first 75+HA were significantly more likely to receive vaccinations than those receiving a subsequent 75+HA (P=0.022). Conclusion 75+HAs fulfil a role in addressing chronic health problems otherwise overlooked during standard GP consultations. What is known about the topic? Since their introduction in 1999, uptake of 75+HAs has been low. Two studies from 2001 to 2002 have suggested benefits of conducting 75+HAs to identify new health problems. What does this paper add? When compared with standard GP consultations, 75+HAs identify different types of new health problems, including elevated lipids, vitamin D deficiencies, eye/vision-related conditions, diabetes, and hearing conditions. Furthermore, more referrals and new management of previously identified problems occur at 75+HA. What are the implications for practitioners? 75+HAs fulfil a role in identifying and addressing chronic health problems in older patients that may otherwise have been overlooked at standard GP consultations. Suggestions of additions to the 75+HA template are made based on common chronic conditions detected in standard consultations but not included currently within the 75+HA.

摘要

目的

研究与患者在过去 24 个月内的标准全科医生就诊相比,他们最近一次 75+HA 时发现了哪些新的健康信息。

方法

测量的参数包括新发现的慢性疾病、以前诊断的慢性疾病的新管理、药物管理、转诊、疫苗接种以及以前诊断的慢性疾病监测的阳性检查结果。这项回顾性患者记录研究从维多利亚州的两个大都市和地区的全科医生诊所收集数据。共纳入了 195 名 75+HA 接受者。

结果

与过去 24 个月的标准全科医生就诊相比,患者最近一次 75+HA 记录的新慢性疾病数量没有显著差异。然而,注意到疾病类型存在显著差异,75+HA 显著更有可能记录到血脂升高(P<0.001)、维生素 D 缺乏(P=0.004)、眼部/视力相关(P=0.011)、糖尿病(P=0.019)和听力状况(P=0.045),而与标准全科医生就诊相比。在 75+HA 时,明显更多的转诊(P<0.001)和以前诊断疾病的新管理(P=0.009)发生。首次接受 75+HA 的患者明显比接受后续 75+HA 的患者更有可能接种疫苗(P=0.022)。

结论

75+HA 在解决标准全科医生就诊中被忽视的慢性健康问题方面发挥作用。

关于这个话题,你已经了解了哪些内容?自 1999 年推出以来,75+HA 的采用率一直很低。两项分别来自 2001 年至 2002 年的研究表明,进行 75+HA 以识别新的健康问题具有益处。本文增加了哪些内容?与标准 GP 咨询相比,75+HA 会发现不同类型的新健康问题,包括血脂升高、维生素 D 缺乏、眼部/视力相关问题、糖尿病和听力问题。此外,在 75+HA 时会发生更多的转诊和以前识别的问题的新管理。

对于从业者来说,这意味着什么?75+HA 在识别和处理老年患者的慢性健康问题方面发挥作用,而这些问题在标准 GP 咨询中可能被忽视。根据标准咨询中发现但目前未包含在 75+HA 中的常见慢性疾病,提出了对 75+HA 模板的补充建议。

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