Steel, N, Hardcastle, AC, Clark, A et al. (6 more authors) (2014) Self-reported quality of care for older adults from 2004 to 2011: a cohort study. Age Ageing, 43 (5). pp. 716-720. ISSN 0002-0729
Abstract
BACKGROUND: little is known about changes in the quality of medical care for older adults over time. OBJECTIVE: to assess changes in technical quality of care over 6 years, and associations with participants’ characteristics. DESIGN: a national cohort survey covering RAND Corporation-derived quality indicators (QIs) in face-to-face structured interviews in participants’ households. PARTICIPANTS: a total of 5,114 people aged 50 or more in four waves of the English Longitudinal Study of Ageing. METHODS: the percentage achievement of 24 QIs in 10 general medical and geriatric clinical conditions was calculated for each time point, and associations with participants’ characteristics were estimated using logistic regression. RESULTS: participants were eligible for 21,220 QIs. QI achievement for geriatric conditions (cataract, falls, osteoarthritis and osteoporosis) was 41% [95% confidence interval (CI): 38-44] in 2004-05 and 38% (36-39) in 2010-11. Achievement for general medical conditions (depression, diabetes mellitus, hypertension, ischaemic heart disease, pain and cerebrovascular disease) improved from 75% (73-77) in 2004-05 to 80% (79-82) in 2010-11. Achievement ranged from 89% for cerebrovascular disease to 34% for osteoarthritis. Overall achievement was lower for participants who were men, wealthier, infrequent alcohol drinkers, not obese and living alone. CONCLUSION: substantial system-level shortfalls in quality of care for geriatric conditions persisted over 6 years, with relatively small and inconsistent variations in quality by participants’ characteristics. The relative lack of variation by participants’ characteristics suggests that quality improvement interventions may be more effective when directed at healthcare delivery systems rather than individuals.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
Keywords: | epidemiology; geriatrics; older people; quality of care; Age Factors; Aged; Aged, 80 and over; Aging; Chi-Square Distribution; Delivery of Health Care; England; Female; Health Care Surveys; Health Services for the Aged; Humans; Logistic Models; Longitudinal Studies; Male; Middle Aged; Patients; Practice Patterns, Physicians’; Quality Indicators, Health Care; Self Report; Time Factors |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 17 Oct 2017 09:02 |
Last Modified: | 17 Oct 2017 09:11 |
Published Version: | http://www.ncbi.nlm.nih.gov/pubmed/25015897 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/ageing/afu091 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:116461 |