School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Hunter New England Local Health District, John Hunter Hospital, New Lambton, New South Wales, Australia.
PLoS One. 2021 Apr 2;16(4):e0249207. doi: 10.1371/journal.pone.0249207. eCollection 2021.
Health assessments have potential to improve health of older people. This study compares long-term health care utilisation, physical functioning, and mortality for women aged 75 years or over who have had a health assessment and those who have not. Prospective data on health service use, physical functioning, and deaths among a large cohort of women born 1921-26 were analysed. Propensity score matching was used to produce comparable groups of women according to whether they had a health assessment or not. The study population included 6128 (67.3%) women who had an assessment, and 2971 (32.7%) women who had no assessment. Propensity matching produced 2101 pairs. Women who had an assessment had more use of other health services, longer survival, and were more likely to survive with high physical functioning compared to women with no assessment. Among women who had good baseline physcial functioning scores, women who had an assessment had significantly lower odds of poor outcomes at 1000 days follow-up compared to women who had no assessment (OR: 0.67, 95%CI: 0.52, 0.85). This large observational study shows the real-world potential for assessments to improve health outcomes for older women. However, they also increased health service use. This increased healthcare is likely to be an important mechanism in improving the women's health outcomes.
健康评估有可能改善老年人的健康状况。本研究比较了接受和未接受健康评估的 75 岁及以上老年女性的长期医疗保健利用、身体功能和死亡率。对一组出生于 1921-1926 年的大量女性的健康服务使用、身体功能和死亡的前瞻性数据进行了分析。根据是否进行了健康评估，使用倾向评分匹配产生了可比的女性组。研究人群包括接受评估的 6128 名（67.3%）女性和未接受评估的 2971 名（32.7%）女性。倾向评分匹配产生了 2101 对。与未接受评估的女性相比，接受评估的女性更多地使用其他医疗服务，生存时间更长，且身体功能较高的存活可能性更大。在基线身体功能评分良好的女性中，与未接受评估的女性相比，接受评估的女性在 1000 天随访时不良结局的可能性显著降低（OR：0.67，95%CI：0.52，0.85）。这项大型观察性研究表明，评估在改善老年女性健康结果方面具有实际潜力。然而，它们也增加了医疗服务的使用。这种增加的医疗保健可能是改善女性健康结果的重要机制。
