Situation of the Elderly Living Alone: Morbidity and Services Provided from the Field of Primary Health Care of Gran Canaria

Abstract

The elderly suffer a greater number of health problems and have greater need for assistance and care. (1) Background: to determine the profile of the elderly who live alone, identified according to the Primary Care Health Record of Gran Canaria, and to analyze the sociodemographic data of the target population and determine the characteristics related to morbidity. (2) Methods: descriptive, prospective, cross-sectional study carried out in the Primary Health Care Management of Gran Canaria. The study population was all adults over 65 years of age living alone. The instrument used was the Drago-Electronic Health Record. Data analysis was carried out using RStudio version 1.1.447 software, and descriptive analysis and inferential analysis were carried out using the Chi-square values, T-test for independent samples, and ANOVA. (3) Results: The sample amounted to 8679 subjects, predominantly female sex (86.14%) and with a mean age of 79.4 years. Of the sample, 6.4% lived alone. Based on the classification by Adjusted Morbidity Groups (AMG), subjects with “moderate complications” predominated at 45.5%. (4) Conclusions: It is necessary to implement this type of stratification tool, which allows interventions to be carried out in elderly people at risk.

Differences in healthcare service utilization in patients with polypharmacy according to their risk level by adjusted morbidity groups: a population-based cross-sectional study

“…Unlike other studies [ 26 , 30 , 34 ], we could not find many statistically significant differences regarding the use of PC services between sexes or between age groups younger and older than 75 years. The most remarkable difference was that the elderly made more telephone consultations and received more home visits because of their more incapacitating conditions.…”

“…Males younger than 75 years were the ones who made a greater use of services, as they were the ones in our population with higher risk levels and complexity indexes, because men usually suffer more from severe and life-threatening illnesses, meaning they must make use of healthcare services and resources more often and they have a shorter life expectancy [ 25 , 40 ]. Our results are clearly opposed to the greater proportion of contacts with the healthcare system by female and elderly people reported in other studies [ 26 , 30 ]. This might be because these studies mainly reported unadjusted numbers of healthcare visits, and when adjusting for individuals with similar levels of chronic conditions, functional limitations, and disability, women have fewer healthcare contacts than males [ 41 ], supporting our results.…”

“…The frequency of contacts with PC described for polypharmacy patients tripled that registered by non-polypharmacy patients, and the group of polypharmacy high risk patients registered the highest mean of contacts with PC, pursuant to the fact that the use of PC increases with the number of medicines consumed [ 12 , 21 , 22 , 25 , 34 ]. Almost all patients with polypharmacy used PC services, while a lower percentage of non-polypharmacy patients were PC users, in line with other studies of patients with chronic diseases and with or without polypharmacy [ 14 , 28 , 30 , 35 , 36 ]. The most common type of contact was medical contact in person, in agreement with other studies performed in the Community of Madrid involving patients with chronic diseases and geriatric patients [ 35 , 36 ].…”

“…High- and medium-risk patients were more prevalent among polypharmacy patients than among those without polypharmacy, as well as when contrasting to the overall population of Madrid or other regions of Spain stratified by the AMG [ 20 , 29 ], although similar to another Spanish study with adults over 65 years living alone [ 30 ]. Younger patients and males showed higher levels of risk and complexity, probably because their severe conditions shortened their life expectancy and men have a shorter lifespan [ 21 ].…”

“…The factors significantly associated with a higher number of contacts with PC by polypharmacy patients were a high level of risk and an elevated weight of the complexity index, since these patients presented with more comorbidities usually requiring further needs for care, which generates higher healthcare expenditures [ 12 , 20 , 21 , 30 ]. The prescription of medicines for these patients should be done with caution, since, as consequence of their complex condition, they may visit multiple medical specialists, who need to carefully communicate with the patient as well as with other physicians and prescribers to be aware of all the medications they are taking and to avoid inappropriate prescribing [ 5 , 32 , 39 , 42 ].…”