Health needs assessment for elderly in primary health care in Zagreb

Abstract

Abstract Background The purpose of any health system is to guarantee access to care for the entire population served. Zagreb population is 'very old', with 17.3% older than 65. The aim is to assess health care needs for elderly in primary health care (PHC). Methods Data on morbidity and visits are recorded in PHC facilities Variation in the mortality rate in 1971-2014 period is analyzing, using descriptive method. Results The highest index of PHC utilization (88.1%) is recorded for the +65 age, with 14.3 visits per capita (vs 7.7 for general population). Acute respiratory infections ranked first in all age groups; the rate per 100 was considerably lower in the ≥65 group than in the 0-19 group (27.82/100 vs 111.20/100). Hypertensive diseases ranked second most common (23.09 per 100) in the age group ≥65, followed by intervertebral disk diseases and other dorsopathies (15.10/100), and neuroses and affective disorders (6.63/100). The prevalence of hypertensive diseases and of intervertebral disk diseases and other dorsopathies was significantly higher in the ≥65 group (χ2=27.3 and χ2=13.43, respectively; p < 0.05 both). Among mortality causes circulatory diseases and neoplasms showes a constant rise during the period 1971-2014 (circulatory diseases 26.4%; neoplasms 83.9%). The highest rise is recorded in group of endocrine and metabolic disease owing diabetes mellitus(159%). Conclusions Many of older people although independent, have multiple chronic conditions and meet criteria for fraility. The number of PHC visits is high, twice in comparison with general population. Health needs are very related to coping with appropriate organization and management of public health services, esspecially of senior- friendly primary care concept. Key messages The aging of the general population influences the type of morbidity and health care needs. The concept of senior-friendly primary care has to be promoted.