What is learned from an Australian older person health assessment?

Abstract

Objective To examine what new health information is identified at a patient's most recent 75+HA compared with their standard GP consultations in the prior 24 months. Methods Parameters measured included newly identified chronic conditions, new management for previously diagnosed chronic conditions, medication management, referrals, vaccinations, and positive test results for the monitoring of previously diagnosed chronic conditions. A retrospective patient record study collecting data from two GP clinics in metropolitan and regional Victoria was undertaken. A total of 195 75+HA recipients were included. Results No significant difference was found in the number of new chronic conditions recorded at patients' most recent 75+HA compared with standard GP consultations in the prior 24 months. However, significant differences in the types of conditions were noted, with 75+HAs significantly more likely to record elevated lipids (P<0.001), vitamin D deficiencies (P=0.004), eye/vision-related (P=0.011), diabetes (P=0.019), and hearing conditions (P=0.045) compared with standard GP consultations. Significantly more referrals (P<0.001) and new management for previously diagnosed conditions (P=0.009) occurred at 75+HA than at standard GP consultations. Patients who were receiving their first 75+HA were significantly more likely to receive vaccinations than those receiving a subsequent 75+HA (P=0.022). Conclusion 75+HAs fulfil a role in addressing chronic health problems otherwise overlooked during standard GP consultations. What is known about the topic? Since their introduction in 1999, uptake of 75+HAs has been low. Two studies from 2001 to 2002 have suggested benefits of conducting 75+HAs to identify new health problems. What does this paper add? When compared with standard GP consultations, 75+HAs identify different types of new health problems, including elevated lipids, vitamin D deficiencies, eye/vision-related conditions, diabetes, and hearing conditions. Furthermore, more referrals and new management of previously identified problems occur at 75+HA. What are the implications for practitioners? 75+HAs fulfil a role in identifying and addressing chronic health problems in older patients that may otherwise have been overlooked at standard GP consultations. Suggestions of additions to the 75+HA template are made based on common chronic conditions detected in standard consultations but not included currently within the 75+HA.