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全科医生不认识的老年人:低风险群体。

Old people not known to the general practitioner: low risk group.

作者信息

Williams E S, Barley N H

出版信息

Br Med J (Clin Res Ed). 1985 Jul 27;291(6490):251-4. doi: 10.1136/bmj.291.6490.251.

Abstract

The elderly patients in a large general practice aged 75 and over who lived at home (n = 877) were divided into two groups according to the general practitioner's knowledge of their risk status and were designated "risk status known" (n = 679) and "risk status not known" (n = 198). Forty-three high risk patients in the risk status known group had a functional disability score and experience of mortality that was not dissimilar to those of elderly people in institutions. The medical and social characteristics of a random sample (n = 150) of the risk status known group, after excluding the high risk patients, were compared with the risk status not known group using a Barber Wallis questionnaire. A response rate of 90% was achieved from both groups and a cumulative risk score was calculated by totalling unfavourable replies to the questions. The risk status not known group, which comprised 14% of the patients who lived at home after correcting for the number who had died and moved, had appreciably less contact with the general practitioners, had an appreciably lower cumulative risk score, were confined at home less because of ill health, were less concerned about their health, and were less in need of nursing attention. The findings of this study suggest that the elderly patients who are not known to their general practitioners are in relatively good health when compared with the patients that the general practitioner knows well.

摘要

一家大型综合诊所中年龄在75岁及以上且居家生活的老年患者(n = 877),根据全科医生对其风险状况的了解被分为两组,分别为“已知风险状况”组(n = 679)和“未知风险状况”组(n = 198)。已知风险状况组中的43名高危患者的功能残疾评分和死亡率与机构中的老年人并无差异。在排除高危患者后,对已知风险状况组的一个随机样本(n = 150)的医学和社会特征,使用巴伯 - 沃利斯问卷与未知风险状况组进行比较。两组的回复率均达到90%,通过对问题的不利回答进行汇总计算累积风险评分。在对死亡和搬走的人数进行校正后,未知风险状况组占居家患者的14%,与全科医生的接触明显较少,累积风险评分明显较低,因健康问题居家的时间较少,对自身健康的担忧较少,对护理的需求也较少。这项研究的结果表明,与全科医生熟知的患者相比,全科医生不了解的老年患者健康状况相对较好。

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