Assessment of the quality of fall detection and management in primary care in the Netherlands based on the ACOVE quality indicators (vol 27, pg 569, 2016)

被引：1

作者：

Askari, M. ^{[1
]}

Eslami, S. ^{[1
]}

van Rijn, M. ^{[2
]}

Medlock, S. ^{[1
]}

van Charante, E. P. Moll ^{[3
]}

van der Velde, N. ^{[2
]}

de Rooij, S. E. ^{[2
]}

Abu-Hanna, A. ^{[1
]}

机构：

[1] Univ Amsterdam, Acad Med Ctr, Dept Med Informat, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

[2] Univ Amsterdam, Acad Med Ctr, Dept Internal Med, Geriatr Med Sect, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

[3] Univ Amsterdam, Acad Med Ctr, Dept Gen Practice, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

来源：

OSTEOPOROSIS INTERNATIONAL | 2016年 / 27卷 / 02期

关键词：

Elderly; Fall detection; Primary care; Quality indicators; Quality of care;

D O I：

10.1007/s00198-016-3498-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We determined adherence to nine fall-related ACOVE quality indicators to investigate the quality of management of falls in the elderly population by general practitioners in the Netherlands. Our findings demonstrate overall low adherence to these indicators, possibly indicating insufficiency in the quality of fall management. Most indicators showed a positive association between increased risk for functional decline and adherence, four of which with statistical significance. Introduction This study aims to investigate the quality of detection and management of falls in the elderly population by general practitioners in the Netherlands, using the Assessing Care of Vulnerable Elders (ACOVE) quality indicators. Methods Community-dwelling persons aged 70 years or above, registered in participating general practices, were asked to fill in a questionnaire designed to determine general practitioner (GP) adherence to fall-related indicators. We used logistic regression to estimate the association between increased risk for functional decline-quantified by the Identification of Seniors At Risk for Primary Care score-and adherence. We then cross-validated the self-reported falls with medical records. Results Of the 950 elders responding to our questionnaire, only 10.6 % reported that their GP proactively asked them about falls. Of the 160 patients who reported two or more falls, or one fall for which they visited the GP, only 23.1 % had fall documentation in their records. Adherence ranged between 13.6 and 48.6 %. There was a significant positive association between the ISAR-PC scores and adherence in four QIs. Documentation of falls was highest (36.7 %) in patients whom the GP had proactively asked about falls. Conclusion Based on patient self-reports, adherence to the ACOVE fall-related indicators was poor, suggesting that the quality of evaluation and management of falls in community-dwelling older persons in the Netherlands is poor. The documentation of falls and fall-related risk factors was also poor. However, for most QIs, adherence to them increased with the increase in the risk of functional decline.

引用

页码：577 / 577

页数：1