Abstract

Health assessments have potential to improve health of older people. This study compares long-term health care utilisation, physical functioning, and mortality for women aged 75 years or over who have had a health assessment and those who have not. Prospective data on health service use, physical functioning, and deaths among a large cohort of women born 1921-26 were analysed. Propensity score matching was used to produce comparable groups of women according to whether they had a health assessment or not. The study population included 6128 (67.3%) women who had an assessment, and 2971 (32.7%) women who had no assessment. Propensity matching produced 2101 pairs. Women who had an assessment had more use of other health services, longer survival, and were more likely to survive with high physical functioning compared to women with no assessment. Among women who had good baseline physcial functioning scores, women who had an assessment had significantly lower odds of poor outcomes at 1000 days follow-up compared to women who had no assessment (OR: 0.67, 95%CI: 0.52, 0.85). This large observational study shows the real-world potential for assessments to improve health outcomes for older women. However, they also increased health service use. This increased healthcare is likely to be an important mechanism in improving the women's health outcomes.

Highlights

  • Age is commonly associated with decline in physical functioning, with many older people experiencing decreased ability to maintain independence in their activities of daily living and instrumental activities

  • A covariate by time interaction was considered significant if the likelihood ratio test for the model including this interaction term indicated a significantly better fit compared to the model without this interaction

  • Unlike earlier studies where assessments were conducted within the context of a trial with protocols for the administration of the assessment and follow-up [12], this study evaluates assessments according to their uptake by women and to how they are delivered by general practitioners within the health system

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Summary

Introduction

Age is commonly associated with decline in physical functioning, with many older people experiencing decreased ability to maintain independence in their activities of daily living and instrumental activities. Comprehensive health assessment with appropriate follow-up of identified needs is one option for prevention of functional decline and other adverse events among older people, and improving their quality of life [1,2,3].

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