Risk strata and quality of care for the elderly in Primary Health Care.
Líliam Barbosa Silva, Patrícia Aparecida Barbosa Silva, Joseph Fabiano Guimarães Santos and 3 others
PMID 31596406WHAT IT FOUND
In 108 elderly patients with hypertension or diabetes in Brazilian primary care, recommended tests and medical or nursing consultations were rarely recorded.
Only 1 of 46 diabetic patients had a foot evaluation, and care did not match risk strata.
Key findings
01In 108 elderly patients, care parameters were rarely recorded: medical consultation was recorded for 56, nursing consultation for 27, and diabetic foot evaluation for only 1 of 46 patients with diabetes.
02Laboratory test compliance was poor: 35 participants completed none of the recommended tests, while only 12 completed all.
03Cluster analysis identified three patient profiles: 40 with better care indicators, 36 with controlled blood pressure and metabolic levels but poor test compliance, and 32 with no test compliance and uncontrolled levels.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot show that care parameters caused better or worse outcomes. Only 108 elderly patients from one health district in Brazil were included, so results may not apply elsewhere. Care information depended on electronic medical records, so care performed elsewhere may not have been recorded. People with severe cognitive impairment were excluded, so findings do not describe people with Mini-Mental State Examination scores of 9 or lower. The pattern-analysis dimensions had low internal reliability, with Cronbach's alpha values of 0.473 and 0.360. Some care parameters were excluded from the main pattern analysis because of probable underreporting, and cardiovascular risk was excluded because of multicollinearity.
Declared interests
Funding was provided by FAPEMIG. No author conflict-of-interest statement is given.
The easy way to misread this
Do not conclude that completing more tests caused better blood pressure or metabolic control. This is a cross-sectional record review, so it can describe patterns but not prove cause.