Assessment of the quality of primary care for the elderly according to the Chronic Care Model

Silva, Líliam Barbosa; Soares, Sônia Maria; Silva, Patrícia Aparecida Barbosa; Santos, Joseph Fabiano Guimarães; Miranda, Lívia Carvalho Viana; Santos, Raquel Melgaço

doi:10.1590/1518-8345.2331.2987

Cited by 24 publications

(31 citation statements)

References 24 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This cross-sectional study is part of the second phase of the population-based study on “Aging and Kidney Disease” (en-DoRen) at the regional level, conducted from August 2014 to January 2017 in one of the nine health districts of Belo Horizonte, Minas Gerais, Brazil 14 .…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Estratos de risco e qualidade do cuidado à pessoa idosa na Atenção Primária à Saúde

Silva

Santos

et al. 2019

Rev. Latino-Am. Enfermagem

Self Cite

View full text Add to dashboard Cite

Objectiveto identify patterns of associations between the degree of compliance to laboratory test requests by risk strata and the parameters of quality of care outcomes in primary health care (PHC).Methoda cross-sectional study involving 108 elderly patients with hypertension and/or diabetes treated in PHC. A semi-structured questionnaire and electronic medical record data were used. To evaluate the quality of care, the Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used. Descriptive analysis, multiple correspondence analysis and k-means grouping were performed.Resultsit was observed low compliance of the care practice, standing out as the worst parameter the evaluation of the diabetic foot (2.2%). Three clusters were identified, with cluster 1 having the highest number of individuals (37.0%), with better indicators of quality of care, evidenced by above 50% of compliance with laboratory tests (75.0%), high PACIC score (47.2%), control of blood pressure (70.0%) and metabolic levels (95.0%), and satisfaction with health (92.5%) and health access (90.0%). In contrast, cluster 3 (29.6%) was made up of individuals with worse outcomes of care.Conclusionlow compliance of care practice and asymmetries among health actions and users’ needs were observed, indicating failures in the care process in PHC.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Blood pressure levels were also measured and biological material was collected to measure the glycemic, lipid profile and renal function parameters. Further details are described in a previous publication 14 .…”

Section: Methodsmentioning

confidence: 99%

Estratos de risco e qualidade do cuidado à pessoa idosa na Atenção Primária à Saúde

Silva

Santos

et al. 2019

Rev. Latino-Am. Enfermagem

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, exclusion criteria consisted of being assisted in PHC for less than 12 months, residing in the rural area and having cognitive impairment [defined as a score ≤5 in the 10-point cognitive screener (10-CS)]. These exclusion criteria were chosen because we considered it is important to have been adequately assisted at a PHC center for a certain period of time to assure the collection of reliable information; significant cognitive impairment causes problems on self-reported data; and rural and urban areas have different characteristics, and approximately 85% of elderly adults live in urban areas [16][17][18].…”

Section: Methodsmentioning

confidence: 99%

VES-13 Role to Identify Limited Life Expectancy in Older Adults in Primary Care Settings

Assis

Chagas

Santos

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Population aging is a phenomenon that represents a challenge to the health systems, especially to settings with limited economic resources. In this scenario, it is essential to perform adequate screening, diagnostic, and therapeutic approaches to reduce health vulnerability. To investigate, for the first time, the potential role of Vulnerable Elders Survey (VES-13) to identify older adults with Limited Life Expectancy (LLE) (defined as estimated 10-year mortality risk ≥ 50%) in Primary Health Care (PHC) settings. Methods: This cross-sectional study was performed in all PHC units in Jatai (Brazil) from July to December 2018. The sample size of 407 elderly individuals was obtained considering an older population (≥60 years old) of 10,853, a 50% prevalence, a 5% margin of error, a 95% confidence level, and 10% of possible losses. Participants answered a questionnaire about sociodemographic and clinical characteristics, including the VES-13 (a tool to identify health vulnerability) and the Suemoto index (an index to estimate 10-year mortality risk for community-dwelling older adults). We tested the association between LLE and VES-13, using multiple logistic regression analysis. In addition, we investigated the discrimination of the VES-13 in identifying individuals with LLE using the area under the receiver operator characteristic curve (AUROC). Results: The mean age was 68.9 ± 6.6yo, and 58% were women. The mean score of VES-13 was 2.0 ± 2.2, the mean score of Suemoto index was 31.5 ± 21.1%, and 17.2% had LLE. The VES-13 was associated with LLE (OR=1.57; p=<0.0001). Moreover, a VES-13 score ≥2 points was able to discriminate LLE (AUROC=0.764 (95%CI=0.078-0.820); sensitivity 81%). Conclusion: VES-13was able to identify older adults with LLE in PHC settings. Thus, the VES-13 could play a role in detecting older adults that would not benefit from screening (e.g., colorectal cancer) and strict control of chronic diseases (e.g., diabetes). However, other longitudinal studies are needed to confirm the role of VES-13 in identifying older adults with LLE, before the VES-13 can be adopted in routine clinical practice decisions in PHC, since we used a prediction model to identify LLE.

show abstract

“…This is a cross-sectional, population-based study, conducted within the regional scope, on older adults living in one of nine health districts of Belo Horizonte, Minas Gerais, Brazil. Data were gathered from a secondary database, based on a major study entitled Envelhecimento e Doença Renal [Aging and Kidney Disease] (en-DoRen) (17) , and collected in the period from August 26, 2014 to November 1st, 2016.…”

Section: Study Design Location and Periodmentioning

confidence: 99%

“…Therefore, remained in the study 46,360 households distributed among 370 census sectors. We highlight that 140 census sectors were grouped into a single sector due to low participation percentage in the region under study, accounting for a total of 5,604 households (17) .…”

Section: Sample and Selection Criteriamentioning

confidence: 99%

Factors associated with metabolic syndrome in older adults: a population-based study

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objective: To estimate the prevalence of the metabolic syndrome and clusters of its components and to identify possible associated factors in older adults. Method: Cross-sectional and population-based study, involving 271 older people. We collected sociodemographic, behavioral, clinical, biochemical, and anthropometric data. Data were analyzed by descriptive and logistic regression techniques. Results: The prevalence of metabolic syndrome was 59% and was associated with women, overweight/obesity, and the C-reactive protein. Concerning the clusters, 11.4% of the sample had all the components of the metabolic syndrome, and only 5.2% of individuals did not have any of its components. Conclusion: We found there is a high prevalence of metabolic syndrome and clusters of its components in older adults. It is important to deepen studies on this matter, considering clinical aspects in relation to sex and healthy behavioral habits for creating public policies as well as emphasizing actions aimed at promoting self-care in all cycles of life.

show abstract

Assessment of the quality of primary care for the elderly according to the Chronic Care Model

Cited by 24 publications

References 24 publications

Estratos de risco e qualidade do cuidado à pessoa idosa na Atenção Primária à Saúde

Estratos de risco e qualidade do cuidado à pessoa idosa na Atenção Primária à Saúde

VES-13 Role to Identify Limited Life Expectancy in Older Adults in Primary Care Settings

Factors associated with metabolic syndrome in older adults: a population-based study

Contact Info

Product

Resources

About