Use of Physician Services by Older Adults: 1991/1992 to 2000/2001

2005 ◽  
Vol 24 (S1) ◽  
pp. 29-36 ◽  
Author(s):  
Diane E. Watson ◽  
Petra Heppner ◽  
Robert Reid ◽  
Bogdan Bogdanovic ◽  
Noralou Roos
Keyword(s):  
Older Adults ◽  
General Population ◽  
Secondary Care ◽  
Physician Visit ◽  
Family Physicians ◽  
Physician Services ◽  
Specialist Visit

ABSTRACTCanadians have expressed concern that access to family physicians (FP) has declined. Anonymized physician services data for 1991/1992 to 2000/2001 were used to evaluate changes in supply and age-specific rates of use of FPs and specialists in Winnipeg, Manitoba. Physician-to-population ratios declined 7.5 per cent, FP-to-population ratios declined 4.8 per cent, and specialist-to-population ratios declined 10.0 per cent. Among the general population, FP visit rates declined 3 per cent. Among older adults, physician visit rates increased 2.3 per cent, FP visit rates increased 10.9 per cent, and specialist visit rates declined 15.7 per cent. By comparison, we document declines in FP use by those younger than 5 years (25.5%) and those 6 to 19 years of age (18.6%). Increases in FP and declines in specialist use occurred primarily among those aged 65 to 84 years. By 2000/2001 older adults accounted for 25 per cent of all FP encounters. Gains in FP use among older adults was less attributable to the presence of more seniors and more related to the fact that a higher proportion of them are visiting a FP each year and, potentially, substituting primary for secondary care.

Subjective life satisfaction and mental disorders among older adults in UAE in general population

2010 ◽  
Vol 25 (5) ◽  
pp. 458-465 ◽  
Author(s):  
Rafia Ghubach ◽  
Omar El-Rufaie ◽  
Taoufik Zoubeidi ◽  
Sufyan Sabri ◽  
Saeed Yousif ◽  
...  
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
General Population ◽  
Mental Disorders

scholarly journals Quality of life of older Chinese adults receiving primary care in Wuhan, China: a multi-center study

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6860 ◽  
Author(s):  
Bao-Liang Zhong ◽  
Yan-Min Xu ◽  
Wu-Xiang Xie ◽  
Xiu-Jun Liu
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Primary Care ◽  
General Population ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Psychosocial Problems ◽  
Medical Conditions ◽  
Multi Center Study

Background Quality of life (QOL) is an important primary care outcome, but the QOL of older adults treated in primary care is understudied in China. This study examined QOL and its associated factors in older adults treated in Chinese primary care. Methods A total of 752 older patients (65+ years) were consecutively recruited from 13 primary care centers in Wuhan, China, and interviewed with a standardized questionnaire, concerning socio-demographics, major medical conditions, loneliness, and depression. QOL and depression were measured with the Chinese six-item QOL questionnaire and the shortened Geriatric Depression Scale, respectively. Multiple linear regression was used to identify factors associated with poor QOL. Results The average QOL score of primary care older adults was (20.7 ± 2.5), significantly lower than that of the Chinese general population. Factors significantly associated with poor QOL of Chinese primary care older adults included engaging in manual labor before older adulthood (unstandardized coefficient [β]: −0.702, P < 0.001), no living adult children (β: −1.720, P = 0.001), physical inactivity (β: −0.696, P < 0.001), having ≥ four major medical conditions (β: −1.813, P < 0.001), hearing problem (β: −1.004, P = 0.017), depression (β: −1.153, P < 0.001), and loneliness (β: −1.396, P < 0.001). Conclusions Older adults treated in Chinese primary care have poorer QOL than the general population. Addressing psychosocial problems at Chinese primary care settings could be helpful in improving QOL in Chinese older adults.

scholarly journals Improving Dementia Care Among Family Physicians: From Stigma to Evidence-Informed Knowledge

2020 ◽  
Vol 23 (4) ◽  
pp. 340-343
Author(s):  
Juanita-Dawne R. Bacsu ◽  
Farrah J. Mateen ◽  
Shanthi Johnson ◽  
Marc D. Viger ◽  
Paul Hackett
Keyword(s):  
Older Adults ◽  
Family Physicians ◽  
Primary Source ◽  
Dementia Care ◽  
Public Health Issue ◽  
Research Education ◽  
People With Dementia ◽  
The Government ◽  
Government Of Canada

Dementia is a national public health issue and a growing concern across Canada. Recently, the Government of Canada released a national dementia strategy focused on the need to prevent dementia, advance therapies, find a cure, and improve the quality of life for people with dementia. Family physicians are a primary source of care in discussing concerns of cognitive health and dementia, especially in rural and remote communities in Canada. However, research indicates that family physicians often lack knowledge and feel ill-equipped in providing care to older adults with dementia. Inadequate knowledge and education of dementia contributes to the stigmatization (stereotypes, labeling, discriminatory practices) of people with dementia and creates barriers to diagnosis and treatment. Moreover, studies show that there is dementia-related stigma among family physicians. We believe that there is a critical gap and urgent need for better dementia education and training among family physicians to improve dementia care, treatment and timely diagnosis. Thus, it is time to rethink our approach to dementia care in Canada, and to recognize that better care of older adults requires more evidence-informed research, education and interprofessional collaboration in order to reduce stigma and improve the quality of care for people with dementia.

The association of loneliness with health and social care utilisation in older adults in the general population: A systematic review

2021 ◽  
Author(s):  
Kimberley J Smith ◽  
Christina Victor
Keyword(s):  
Older Adults ◽  
General Population ◽  
Social Care ◽  
Care Home ◽  
Service Utilisation ◽  
Study Quality ◽  
Cross Sectional ◽  
Consistent Finding ◽  
Care Utilisation ◽  
Health And Social Care

Abstract Background and Objectives Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilisation (HSCU) in older adults from the general population. Research Design and Methods Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as majority of sample 60 or older). Study quality was assessed with the NIH scale for observational cohorts and cross-sectional studies. Results We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n=1), and CVD-specific hospitalisation (n=1). Once adjusted for confounders the highest quality studies found no association of baseline loneliness with physician utilisation, outpatient service utilisation, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining, studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. Discussion and implications There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between two good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences additional good quality longitudinal research is needed.

scholarly journals Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035012
Author(s):  
Marlies Feenstra ◽  
Barbara C van Munster ◽  
Janet L MacNeil Vroomen ◽  
Sophia E de Rooij ◽  
Nynke Smidt
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
General Population ◽  
Health Risk ◽  
Chronic Diseases ◽  
Community Dwelling ◽  
Endocrine Function ◽  
Self Rated Health ◽  
Physiological Markers ◽  
Community Dwelling Older Adults

ObjectivesPoor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and settingProspective general population cohort.ParticipantsTrajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measuresTrajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).ResultsFour stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.ConclusionSRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.

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