Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Am Geriatr Soc. 2021 Jun;69(6):1592-1600. doi: 10.1111/jgs.17088. Epub 2021 Mar 5.
Community health centers (CHCs) are federally funded safety-net clinics that provide care to low income and medically underserved persons. The proportion of CHC patients aged ≥65 doubled in the last ten years, yet little is known about this population. We aim to describe the demographic and clinical characteristics of the older adult CHC population.
Cross sectional analysis.
The nationally representative 2014 Health Center Patient Survey.
CHC patients ≥55 years.
We used descriptive statistics to characterize older adults across demographic and clinical variables. To determine differences by age, we stratified into three groups (55-64, 65-74, 75+ years). We used t-tests and chi-squared to calculate p values and survey weights to make national estimates.
We included 1875 older adults ≥55 years, representing over 4.2 million people. Older adults were mostly aged 55-64 (60%), female (51%), and white (60%). The majority (73%) had Medicare or Medicaid and 47% reported fair or poor health. Regardless of age, older adults had an average of three chronic conditions and 0.6 impairments in activities of daily living (ADL). Healthcare utilization was not significantly different across age groups with most taking ≥5 prescription medications (54%) and one in five reporting ≥2 emergency department visits or ≥1 hospitalization in the last year.
Adults 55-64 who attend CHCs have similar disease burden as adults ≥65. As the population of older adults who access CHCs grow, our findings highlight the opportunity to enhance focus on key principles of geriatric medicine, such as measurement of functional impairment for those who are <65 while also addressing underlying health disparities.
社区卫生中心（CHC）是由联邦政府资助的医疗服务机构，为低收入和医疗服务不足的人群提供医疗服务。在过去十年中，CHC 患者中年龄≥65 岁的比例增加了一倍，但对这一人群知之甚少。我们旨在描述老年 CHC 人群的人口统计学和临床特征。
横断面分析。
具有全国代表性的 2014 年卫生中心患者调查。
年龄≥55 岁的 CHC 患者。
我们使用描述性统计数据来描述不同人口统计学和临床变量的老年人特征。为了确定年龄差异，我们将其分为三组（55-64 岁、65-74 岁、75+岁）。我们使用 t 检验和卡方检验计算 p 值，并使用调查权重进行全国估计。
我们纳入了 1875 名年龄≥55 岁的老年人，代表了超过 420 万人。老年人中，年龄在 55-64 岁的占 60%，女性占 51%，白人占 60%。大多数人（73%）拥有医疗保险或医疗补助，47%的人报告健康状况一般或较差。无论年龄大小，老年人平均有三种慢性病，0.6 种日常生活活动（ADL）受损。各年龄组的医疗保健利用率无显著差异，大多数人服用≥5 种处方药（54%），五分之一的人报告在过去一年中至少有两次急诊就诊或一次住院治疗。
55-64 岁到 CHC 就诊的成年人与≥65 岁的成年人的疾病负担相似。随着年龄在 65 岁以上的 CHC 就诊人群的增长，我们的研究结果强调了加强关注老年医学关键原则的机会，例如为年龄<65 岁的人测量功能障碍，同时解决潜在的健康差异。
