Escola de Economia e Gestão, Universidade do Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
BMC Geriatr. 2022 Jul 6;22(1):561. doi: 10.1186/s12877-022-03104-5.
Development has promoted longer and healthier lives, but the rise in the proportion of older adults poses new challenges to health systems. Susceptibilities of older persons resulting from lower knowledge about services availability, health illiteracy, lower income, higher mental decline, or physical limitations need to be identified and monitored to assure the equity and quality of health care. The aim of this study was to develop equity indicators for the Assessing Care of Vulnerable Elders (ACOVE)-3 checklist and perform the first cross-cultural adaptation and validation of this checklist into Portuguese.
A scoping literature review of determinants or indicators of health (in)equity in the care of older people was performed. A total of 5 language experts and 18 health professionals were involved in the development and validation of the equity and quality indicators through expert opinion and focus groups. Data collected from focus groups was analyzed through directed or conventional content analysis. The usefulness of the indicators was assessed by analyzing the clinical records of 30 patients.
The literature review revealed that there was a worldwide gap concerning equity indicators for older people primary health care. A structured and complete checklist composed of equity and quality indicators was obtained, validated and assessed. A significant number of non-screened quality or equity related potential occurrences that could have been avoided if the proposed indicators were implemented were detected. The percentage of non-registered indicators was 76.6% for quality and 96.7% for equity.
Applying the proposed checklist will contribute to improve the monitoring of the clinical situation of vulnerable older people and the planning of medical and social actions directed at this group.
发展延长了人们的寿命并提高了生活质量，但老年人口比例的上升给卫生系统带来了新的挑战。老年人由于对服务可用性的了解较少、健康素养较低、收入较低、精神衰退较高或身体限制等原因而变得脆弱，需要识别和监测这些脆弱性，以确保医疗保健的公平性和质量。本研究旨在为脆弱老年人评估工具（ACOVE）-3 检查表开发公平性指标，并首次对该检查表进行跨文化适应性改编和验证。
对老年人护理中健康（公平）的决定因素或指标进行了广泛的文献回顾。共有 5 位语言专家和 18 位卫生专业人员通过专家意见和焦点小组参与了公平性和质量指标的制定和验证。通过定向或常规内容分析对焦点小组收集的数据进行分析。通过分析 30 名患者的临床记录来评估指标的有用性。
文献综述表明，全球在老年人初级保健公平性指标方面存在差距。获得、验证和评估了一个由公平性和质量指标组成的结构化、完整的检查表。检测到大量非筛查的与质量或公平性相关的潜在问题，如果实施了拟议的指标，这些潜在问题本可以避免。质量方面未记录的指标占 76.6%，公平性方面未记录的指标占 96.7%。
应用拟议的检查表将有助于改善对脆弱老年人临床状况的监测，并规划针对该群体的医疗和社会行动。
