Internal Medicine Residents' Ambulatory Management of Core Geriatric Conditions
| Autor: | Juliessa M Pavon, Jan Busby-Whitehead, Janice S. Lawlor, James Lovato, Kathryn E. Callahan, William P. Moran, Thomas O. Dalton, Justin Marsden, Hal H. Atkinson, Ellen Roberts, Patricia Iverson, Jeff D. Williamson, Lindsay A. Wilson, Mitchell T. Heflin |
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| Rok vydání: | 2016 |
| Předmět: |
Gerontology
medicine.medical_specialty Outpatient Clinics Hospital Patient demographics Vulnerable elders MEDLINE Audit Age and sex 01 natural sciences 03 medical and health sciences 0302 clinical medicine Internal medicine Physicians Internal Medicine Prevalence Medicine Outpatient clinic Humans 030212 general & internal medicine 0101 mathematics Aged Original Research Geriatrics Aged 80 and over Primary Health Care business.industry 010102 general mathematics Internship and Residency General Medicine Continuity of Patient Care United States Family medicine Ambulatory Chronic Disease Clinical Competence business |
| Zdroj: | Journal of graduate medical education. 9(3) |
| ISSN: | 1949-8357 |
| Popis: | Background Adults aged 65 years and older account for more than 33% of annual visits to internal medicine (IM) generalists and specialists. Geriatrics experiences are not standardized for IM residents. Data are lacking on IM residents' continuity experiences with older adults and competencies relevant to their care. Objective To explore patient demographics and the prevalence of common geriatric conditions in IM residents' continuity clinics. Methods We collected data on age and sex for all IM residents' active clinic patients during 2011–2012. Academic site continuity panels for 351 IM residents were drawn from 4 academic medical center sites. Common geriatric conditions, defined by Assessing Care of Vulnerable Elders measures and the American Geriatrics Society IM geriatrics competencies, were identified through International Classification of Disease, ninth edition, coded electronic problem lists for residents' patients aged 65 years and older and cross-checked by audit of 20% of patients' charts across 1 year. Results Patient panels for 351 IM residents (of a possible 411, 85%) were reviewed. Older adults made up 21% of patients in IM residents' panels (range, 14%–28%); patients ≥ 75 (8%) or 85 (2%) years old were relatively rare. Concordance between electronic problem lists and chart audit was poor for most core geriatric conditions. On chart audit, active management of core geriatric conditions was variable: for example, memory loss (10%–25%), falls/gait abnormality (26%–42%), and osteoporosis (11%–35%). Conclusions The IM residents' exposure to core geriatric conditions and management of older adults was variable across 4 academic medical center sites and often lower than anticipated in community practice. |
| Databáze: | OpenAIRE |
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