Perceived Risk of Death in Older Primary Care Patients

Abstract

There is a large gap between life expectancy and healthy life years at age 65. To reduce this gap, it is necessary that people with medical concerns perceived at higher risk of adverse outcomes are readily identified and treated. The same goes for the need to implement prevention plans. The main objectives of this study are to, in a first step, (a) estimate the percentage of medical concerns, (b) identify factors associated with this concern; in a second step, (c) estimate the perceived risk of death, and (d) evaluate the ability of medical concerns to predict this risk. Results show that the existence and severity of medical concerns are crucial in the prediction of perceived risk of death. Early identification of severity of medical concerns and the availability and adequacy of informal caregiving should allow healthcare professionals to promptly initiate an appropriate assessment and treatment of older patients.

Validation of the Portuguese Version of the Risk Instrument for Screening in the Community (RISC) Among Older Patients in Primary Care in Northern Portugal

“…The severity of medical and ADL's concerns were also able to predict the occurrence of death (AUC of 0.73). This reflects results obtained by Teixeira et al who identified the severity of medical concerns as the best predictive factor for the risk of death as perceived by GPs (45). The same study showed that if the caregiver network is unable to deal with medical problems at home, the perception of the probability of death within a year by GPs is 65 times higher for those at maximum risk compared those classified as lower risk.…”

The Perceived Risk of Hospitalization in Primary Health Care – The Importance of Multidimensional Assessment

“…In 2015, over 80% of hospitalizations that could have been avoided occurred in people over 65 years of age ( Rocha et al, 2020 ). PHC is the ideal place for identifying and referring elderly people at risk ( Garrard et al, 2020 ; Rocha et al, 2020 ; Rubenstein et al, 1991 ), with the GP being the privileged counterpart for such identification ( Moons et al, 2012 ; Teixeira et al, 2017 ). The relationship of proximity and continuity gives the GPs the necessary knowledge to perform a multidimensional assessment of the patient’s health condition and, thus, to assess the potential risk of adverse events ( Moons et al, 2012 ; Teixeira et al, 2017 ).…”

Perceived risk of institutionalization, hospitalization, and death in oldest old primary care patients

“…Specifically in Portugal, the National Health Service (NHS) covers the whole population, and primary health care is the central pillar of the Portuguese health system (Barros et al, 2011;Fernandes et al, 2017). General practitioners (GPs) treat and monitor patients and their families for a long period of time, assuming a relevant role in preventing or treating disease and its adverse outcomes; as a privileged group of healthcare providers, they have an exclusive view about the risk condition of each patient (Barros et al, 2011;Teixeira et al, 2016).…”