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PMID: 18703659 Published · epublish English Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Self reported receipt of care consistent with 32 quality indicators: national population survey of adults aged 50 or more in England.

BMJ (Clinical research ed.) ·Vol. 337 ·2008-08-13 ·Pages a957

Steel N, Bachmann M, Maisey S, Shekelle P, Breeze E, Marmot M, Melzer D

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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Article Info
Journal
BMJ (Clinical research ed.)
Abbr.
BMJ
ISSN
1756-1833
Published
2008-08-13
Epub
2008-00-13
Pages
a957
Language
English
Region
England
NLM ID
8900488
PMCID
PMC2515887
Subset
IM
Grants
Medical Research Council · G19/35 · United Kingdom
Medical Research Council · G0100222 · United Kingdom
Department of Health · United Kingdom
Medical Research Council · G8802774 · United Kingdom
British Heart Foundation · RG/07/008/23674 · United Kingdom
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