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Geriatric screening in a rural practice: the financial implications.

K J Kestin, R V Savage

    The British Journal of General Practice : the Journal of the Royal College of General Practitioners
    |December 1, 1990
    PubMed
    Summary

    Identifying at-risk elderly patients through primary health care screening revealed significant unmet needs. Targeted screening for those aged 75 and over, using opportunistic methods, can reduce costs while ensuring essential support for vulnerable seniors.

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    Area of Science:

    • Geriatric Medicine
    • Primary Health Care
    • Health Services Research

    Background:

    • Elderly populations often have complex health and social needs.
    • Identifying at-risk individuals in primary care is crucial for timely intervention.
    • Existing screening methods may not be cost-effective or comprehensive.

    Purpose of the Study:

    • To assess the prevalence of unmet needs in elderly patients using specific risk factors.
    • To evaluate the validity of chosen risk criteria as indicators of unmet need.
    • To determine the cost-effectiveness of different screening strategies for the elderly.

    Main Methods:

    • A random 10% sample of patients aged 65+ in a rural practice were screened.
    • Five 'at risk' categories were defined: living alone, inability to prepare food, no telephone, recent bereavement, recent hospital discharge.

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  • Costs of screening and associated services were calculated.

    • Main Results:

    • 39% of screened elderly patients (65+) had at least one risk factor.
    • Screening all independent elderly patients (65+) cost £16,600, revealing £45,151 in annual unmet needs.
    • Opportunistic screening of those 75+ could reduce costs from £7,560 to £1,925.

    Conclusions:

    • A significant proportion of independent elderly patients face unmet needs.
    • Targeted screening, focusing on the 75+ age group and utilizing opportunistic methods, is more cost-effective.
    • Proactive inquiry during primary care contacts is essential to identify and address unmet needs in the elderly.