Planning Health Services for Seniors: Can We Use Patient’s Own Perception?

Abstract

ObjectivesThe objectives of this study were to identify needs and to estimate whether self-reported health can be used as an indicator of service needs among seniors.MethodsThis was a cross-sectional survey. Age- and sex-adjusted logistic regression was used to estimate the link between functional status indicators and fair or poor self-reported health. Forward stepwise logistic regression was performed to identify the strongest contributors of poor health. Positive predictive value (PPV), sensitivity, and specificity were calculated to identify whether health perception could be used to identify people in need of physical rehabilitation services.Results142 seniors agreed to answer the survey, yielding a response rate of 73%. Among the respondents (mean age 79±7; 60% women), 40% rated their health as fair or poor. Seniors perceiving their health as fair or poor had higher odds of reporting impairments, activity limitations, and participation restrictions (OR ranging from 2.37 95%CI: 1.03-5-45 to 12.22 95%CI: 2.68–55.78) in comparison to those perceiving their health as good or better. The strongest contributors for poor/fair health were depression, difficulty performing household tasks, pain, and dizziness (c-statistic = 0.91 and a maximum adjusted r-squared of 0.60). Self-rated health used as single-item showed a positive predictive value (PPV) of 1, sensitivity of 52%, and specificity of 100%.ConclusionOur results indicate that all seniors participating in this study and reporting fair or poor health have indicators of need for further rehabilitation services. Asking patients to rate their own health may be an alternate way of querying about need, as many older persons are afraid to report disability because of fear of further institutionalization.

Utilization of medical rehabilitation services among older Poles: results of the PolSenior study

“…Our study indicated no association between SRH and participation in medical rehabilitation, whereas Figueiredo et al [ 39 ] found SRH to be a useful tool for evaluating medical service needs among older adults discharged from the hospital. Potential reason for the aforementioned difference could be the methodology of presented surveys since the PolSenior study group comprised of community dwellers.…”

Community ambulation in older adults and people with OA – a model verification using Canadian Longitudinal Study on Aging (CLSA) data

“…General health perception is a variable in the latent factor of health perception. In a Canadian study, older adults recently discharged from hospital with poor self-rated general health were 3.9 times more likely to have difficulty walking in the community compared to those with good self-rated general health [ 57 ]. A study in Japan found that there was a trend of a higher proportion of people with fair or poor self-rated health when the frequency of going outdoors was low [ 3 ].…”

Rehabilitation needs screening to identify potential beneficiaries: a scoping review

“…25 It has been suggested to describe a rehabilitation need based on an individual's self-reported health. 26 A disagreement in rehabilitation potential, however, can be noted between people's self-perception, which is influenced by their own awareness about rehabilitation services and their benefits, and health worker or carer assessment. 27 28 Even among health service sites, significant variations exist when conducting rehabilitation eligibility selection processes.…”