Background The rapid aging of the world’s population requires systems that support health facilities’ provision of integrated care at multiple levels of the health care system. The use of health information systems (HISs) at the point of care has shown positive effects on clinical processes and patient health in several settings of care. Objective We sought to describe HISs for older persons (OPs) in select government tertiary hospitals and health centers in the Philippines. Specifically, we aimed to review the existing policies and guidelines related to HISs for OPs in the country, determine the proportion of select government hospitals and health centers with existing health information specific for OPs, and describe the challenges related to HISs in select health facilities. Methods We utilized the data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail), a cross-sectional and ethics committee–approved study. A facility-based listing of services and human resources specific to geriatric patients was conducted in purposively sampled 27 tertiary government hospitals identified as geriatric centers and 16 health centers across all regions in the Philippines. We also reviewed the existing policies and guidelines related to HISs for OPs in the country. Results Based on the existing guidelines, multiple agencies were involved in the provision of services for OPs, with several records containing health information of OPs. However, there is no existing HIS specific for OPs in the country. Only 14 (52%) of the 27 hospitals and 4 (25%) of the 16 health centers conduct comprehensive geriatric assessment (CGA). All tertiary hospitals and health centers are able to maintain medical records of their patients, and almost all (26/27, 96%) hospitals and all (16/16, 100%) health centers have data on top causes of morbidity and mortality. Meanwhile, the presence of specific disease registries varied per hospitals and health centers. Challenges to HISs include the inability to update databases due to inadequately trained personnel, use of an offline facility–based HIS, an unstable internet connection, and technical issues and nonuniform reporting of categories for age group classification. Conclusions Current HISs for OPs are characterized by fragmentation, multiple sources, and inaccessibility. Barriers to achieving appropriate HISs for OPs include the inability to update HISs in hospitals and health centers and a lack of standardization by age group and disease classification. Thus, we recommend a 1-person, 1-record electronic medical record system for OPs and the disaggregation and analysis across demographic and socioeconomic parameters to inform policies and programs that address the complex needs of OPs. CGA as a required routine procedure for all OPs and its integration with the existing HISs in the country are also recommended.
Objective. To estimate the prevalence of diabetes among Filipino older persons living in the community.Methodology. A cross-sectional analysis was done on a random sample of persons 60 years and older from the Focused Interventions for Frail Older Adults Research and Development Program (2018-2019). A diagnosis of diabetes was established by self-reported physician's diagnosis or if the person was on any antihyperglycemic drugs.Results. The prevalence of self-reported diabetes was 20.5%, with no difference in age, sex, education, or body mass index between older persons with and without diabetes. The presence of 2 or more comorbidities was significantly more common among older persons with diabetes (p<0.001). Visual impairment (p<0.01), hypertension (p<0.001) and hyperlipidemia (p<0.001) were more frequent among those with diabetes. Conclusion.Diabetes is prevalent among community-living older Filipinos. Therefore, effective public health measures for diabetes prevention and management are needed for the ever-growing older population, who are at the highest risk for morbidity and mortality.
BACKGROUND The rapid aging of the world’s population requires systems that support health facilities provision of integrated care at multiple levels of the health care system. Health information system (HIS) that maintains “one person, one record” facilitates efficient provision of services for older persons (OP) and the use of HIS at the point of care have shown positive impacts on clinical processes and patient health in multiple settings of care. OBJECTIVE Objectives 1. To review the existing policies and guidelines related to health information system (HIS) for older persons (OPs) in the Philippines 2. To determine the proportion of select hospitals and health centers that conduct comprehensive geriatric assessment (CGA). 3. To describe the status and challenges related to health information system in select tertiary hospitals and health centers. METHODS The study utilized a cross-sectional study design. Data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail). A facility-based listing of services and workforce specific to geriatric patients was conducted in twenty-seven (27) tertiary hospitals identified as Geriatric Centers across all regions and sixteen (16) health centers within their catchment area. Policies and existing literature on HIS were also reviewed. RESULTS Based on the existing policies, there were multiple agencies involved in the provision of services for OP, with multiple records containing health information and status of OPs. There is no system to integrate or enable interoperability of data systems of OPs at primary, secondary or tertiary levels of care. Hence, a provider for an OP would be unable to access medical, social or insurance information in a single record. Geriatric syndromes including frailty, malnutrition, dementia, incontinence, polypharmacy, and others were not regularly reported as part of the National Health Data Dictionary. Furthermore, reporting based on age group classification is not uniform across facilities. Only 14 (52%) of the hospitals identified as Geriatric Centers while 4 (25%) of the health centers conduct CGA. All tertiary hospitals (27) and health centers (16) are able to maintain medical records of their patients. The tertiary hospitals have better registries on diseases such as CVD, stroke, heart attack, cancer, and mental disorders while health centers have better registries on risk factors such as hypertension, diabetes, but are also able to capture respiratory diseases and disabilities. The updating of databases is not regularly done. Reasons for this include inadequately trained personnel, limited offline facility based HIS, unstable internet connection, and technical issues. CONCLUSIONS Current HIS for OPs are characterized by fragmentation, multiple sources of health information and inaccessibility. Barriers to achieving appropriate HIS for OPs include inability to update HIS in hospitals and health centers and lack of age group and disease standardization. A one-person, one-record electronic medical record system for OP is recommended to address their complex needs and extract data to inform policies and programs. Furthermore, the data on OP shall be disaggregated and analyzed across geographic and social parameters in order to identify gaps in programs and provision of services. Lastly, we recommend the conduct of CGA in all older persons and integrate it in the existing HIS in the country. CLINICALTRIAL Not applicable
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