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Characteristics of older adults in primary care who may benefit from primary palliative care in the United States
Article
CONTEXT: Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care.
OBJECTIVES: To describe U.S. primary care visits among adults 65 years and older with advanced illness.
METHODS: Cross-sectional analysis of the National Ambulatory and Hospital Ambulatory Medical Care Surveys (2009-2011) was conducted using chi-square tests to compare visits without and with advanced illness to U.S. primary care defined by NCQA Palliative and End-of-Life Care Physician Performance Measurement Set ICD-9 codes for end-stage illness.
RESULTS: Among visits by older adults to primary care, 7.9% of visits were related to advanced illness. A higher proportion of advanced illness visits was among males vs. females (8.9% vs. 7.2%; P=0.03) and adults aged 75 and older, non-Hispanic Whites (8.3%) and Blacks (8.2%) vs. Hispanic (6.7%) and non-Hispanic other (2.5%) (P=0.02), dually eligible for Medicare and Medicaid, and from patient Zip Codes with lower median household incomes (below $32,793). A higher percentage of visits with advanced illness conditions to primary care was COPD, CHF, dementia, and cancer, and symptoms reported with these visits were mostly pain, depression, anxiety, fatigue, and insomnia.
CONCLUSION: In the United States, approximately 8% of primary care visits among older adults was related to advanced illness conditions. Advanced illness visits were most common among those most likely to be socio-economically vulnerable and highlight the need to focus efforts for high quality palliative care for these populations.
http://dx.doi.org/10.1016/j.jpainsymman.2017.09.002
Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 55»
Autres numéros de la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»
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