Vulnerable Older People in the Community: Relationship Between the Vulnerable Elders Survey and Health Service Use

Autor: Anthony Montgomery, Maja Barker, Hannah McGee, Desmond O'Neill, Ronán Michael Conroy, Ann O'Hanlon, Anne Hickey
Rok vydání: 2008
Předmět:
Zdroj: Journal of the American Geriatrics Society. 56:8-15
ISSN: 1532-5415
0002-8614
DOI: 10.1111/j.1532-5415.2007.01540.x
Popis: OBJECTIVES: The Vulnerable Elders Survey (VES), a re-cently developed screening tool for at-risk older people inthecommunity,hasbeenvalidatedintheUnitedStates.Thisstudy evaluated its profile in older Irish people. It assessedwhether those categorized as vulnerable according to theVES were likely to use health services more frequently thanothers.DESIGN: Nationally representative cross-sectional inter-views.SETTING: Private homes in the community.PARTICIPANTS: Randomly selected older people (aged 65) (N52,033; 68% response).MEASUREMENTS: Interviews included the 13-item VESand questions on health service use.RESULTS: The proportion scoring as vulnerable was iden-tical to the U.S. sample (32.1% vs 32.3%). At the commu-nity healthcare level, participants categorized as vulnerablevisited their primary care physician more frequently (meanvisits 6.7 vs 4.0, Po.001), had more home-based publichealth nurse visits (29% vs 5%, Po.001), and were morelikely to have had preventive influenza vaccinations (81%vs 72%, Po.001) in the previous year. More-vulnerableolder adults did not differ on assessment of blood pressure(97% vs 96%), cholesterol (82% vs 85%), or receipt ofsmoking advice (66% vs 52%). Vulnerable participantswere more likely to have used emergency department (17%vs 8%, Po.05), inpatient (21% vs 12%, Po.05), and out-patient (28% vs 21%, Po.05) hospital services. Fourteenpercent of those categorized as vulnerable had zero or onevisit to their family physician in the previous year.CONCLUSION: This study provides further evidence,from a different healthcare system, of the potential of theVES to differentiate more-vulnerable older people. Pro-spective studies are needed to assess use of the VES as aclinical decision aid for community professionals such asfamily physicians and public health nurses. J Am GeriatrSoc 56:8–15, 2008.Key words: vulnerability; frailty; Vulnerable EldersSurvey; health service use
Databáze: OpenAIRE
Externí odkaz: