Clinic-based primary care of frail older patients in California
| Autor: | C H, Hirsch, C H, Winograd |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Hospitals
County Social Work Outpatient Clinics Hospital Time Factors Primary Health Care Hospitals Veterans Frail Elderly Community Health Centers Ambulatory Care Facilities California Patient Care Planning United States Hospitals Private House Calls Appointments and Schedules Geriatrics Medicare Assignment Group Practice Humans Education Medical Continuing Medical History Taking Physical Examination Aged Research Article |
| Zdroj: | The Western journal of medicine. 156(4) |
| ISSN: | 0093-0415 |
| Popis: | We surveyed medical directors of primary care clinics in California to learn how those clinics cared for their frail older patients. Of 143 questionnaires sent, 127 (89%) were returned. A median of 30% of all patient encounters were with persons aged 65 or older, and a median of 20% of older patients were considered frail. A total of 20% of the clinics routinely provided house calls to homebound elderly patients. Of clinics involved in training medical students of physicians (teaching clinics), 70% had at least one physician with an interest in geriatrics, compared with 42% of nonteaching clinics (P less than .005). For frail patients, 40% of the clinics routinely performed functional assessment, while 20% routinely did an interdisciplinary evaluation. Continuing education in geriatrics emerged as a significant independent correlate of both functional assessment and interdisciplinary evaluation. Among the 94 clinics with a standard appointment length for the history and physical examination, only 11 (12%) allotted more than 60 minutes for frail patients. The data suggest that certain geriatric approaches are being incorporated into clinic-based primary care in California but do not provide insight into their content or clinical effects. |
| Databáze: | OpenAIRE |
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