A semi-structured computerized screening interview for the assessment of older patients in the primary care setting Academic Article uri icon

abstract

  • Preventive primary care outreach (PPCO) interventions aimed at older people are associated with a reduction of mortality and an increased likelihood for continuing to reside in the community. We describe a comprehensive computerized PPCO program and present initial evaluation of the program. We performed an observational cohort study based in community primary care clinics in the southern district of Israel. Patients older than 75 years, or those more than 65 years of age who had undergone two or more acute admissions in the previous year, were screened by means of an interactive computerized questionnaire that consisted of functional, medical, cognitive/affective, medications, social, and preventive domains. The patient response determined whether the appropriate intervention would be implemented by the primary care team (orange pathway) or required geriatric consultation (red pathway) The initial evaluation of the project included 396 patients with an average age of 78.4 years (SD 6.1) of whom 32.8% were men. A total of 253 (64%) patients were determined to be in the "red" pathway and 143 (36%) in the "orange" pathway. Health care use for those in the "red" pathway was significantly higher than for those in the "orange", with screening questions correctly placing patients in the "red" pathway. To the best of our knowledge, this is the first description of an interactive Computerized PPCO designed to screen elderly patients systematically in the community. An ongoing national evaluation of this study will determine whether this approach will allow more efficient utilization of health services.

publication date

  • January 1, 2009