Abstract
To assess the receipt of effective healthcare interventions in England by adults aged 50 or more with serious health conditions. National structured survey questionnaire with face to face interviews covering medical panel endorsed quality of care indicators for both publicly and privately provided care. Private households across England. 8688 participants in the English longitudinal study of ageing, of whom 4417 reported diagnoses of one or more of 13 conditions. Percentage of indicated interventions received by eligible participants for 32 clinical indicators and seven questions on patient centred care, and aggregate scores. Participants were eligible for 19 082 items of indicated care. Receipt of indicated care varied substantially by condition. The percentage of indicated care received by eligible participants was highest for ischaemic heart disease (83%, 95% confidence interval 80% to 86%), followed by hearing problems (79%, 77% to 81%), pain management (78%, 73% to 83%), diabetes (74%, 72% to 76%), smoking cessation (74%, 71% to 76%), hypertension (72%, 69% to 76%), stroke (65%, 54% to 76%), depression (64%, 57% to 70%), patient centred care (58%, 57% to 60%), poor vision (58%, 54% to 63%), osteoporosis (53%, 49% to 57%), urinary incontinence (51%, 47% to 54%), falls management (44%, 37% to 51%), osteoarthritis (29%, 26% to 32%), and overall (62%, 62% to 63%). Substantially more indicated care was received for general medical (74%, 73% to 76%) than for geriatric conditions (57%, 55% to 58%), and for conditions included in the general practice pay for performance contract (75%, 73% to 76%) than excluded from it (58%, 56% to 59%). Shortfalls in receipt of basic recommended care by adults aged 50 or more with common health conditions in England were most noticeable in areas associated with disability and frailty, but few areas were exempt. Efforts to improve care have substantial scope to achieve better health outcomes and particularly need to include chronic conditions that affect quality of life of older people.
MeSH Terms
Aged
Aged, 80 and over
Chronic Disease/therapy
Delivery of Health Care/standards
England
Family Practice/standards
Health Services for the Aged/standards
Humans
Longitudinal Studies
Middle Aged
Quality Indicators, Health Care
Quality of Life
Authors & Affiliations
7 authors, click to expand affiliations / ORCID
Steel Nicholas
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ.
[email protected]
Bachmann Max
Maisey Susan
Shekelle Paul
Breeze Elizabeth
Marmot Michael
Melzer David
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