1. Assessment of the quality of fall detection and management in primary care in the Netherlands based on the ACOVE quality indicators
- Author
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Askari, M., Eslami, S., van Rijn, M., Medlock, S., Moll van Charante, E.P., van der Velde, N., de Rooij, S.E., Abu-Hanna, A., Sub Software Production, Software Production, Lifelong Learning, Education & Assessment Research Network (LEARN), APH - Amsterdam Public Health, Medical Informatics, ACS - Amsterdam Cardiovascular Sciences, General practice, AMS - Amsterdam Movement Sciences, Geriatrics, Other Research, Sub Software Production, and Software Production
- Subjects
Male ,Gerontology ,Quality Assurance, Health Care ,Frail Elderly ,Endocrinology, Diabetes and Metabolism ,Poison control ,Quality indicators ,Logistic regression ,Research Support ,Vulnerable Populations ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Elderly ,Injury prevention ,Fall detection ,Primary care ,Quality of care ,Journal Article ,Humans ,Medicine ,030212 general & internal medicine ,Disease management (health) ,Non-U.S. Gov't ,Geriatric Assessment ,Aged ,Netherlands ,Quality Indicators, Health Care ,Aged, 80 and over ,Primary Health Care ,business.industry ,Medical record ,Research Support, Non-U.S. Gov't ,Health services research ,Disease Management ,Human factors and ergonomics ,030208 emergency & critical care medicine ,Practice Guidelines as Topic ,Accidental Falls ,Female ,Original Article ,Clinical Competence ,Guideline Adherence ,Health Services Research ,Erratum ,Family Practice ,business - Abstract
UNLABELLED: We determined adherence to nine fall-related ACOVE quality indicators to investigate the quality of management of falls in the elderly population by general practitioners in the Netherlands. Our findings demonstrate overall low adherence to these indicators, possibly indicating insufficiency in the quality of fall management. Most indicators showed a positive association between increased risk for functional decline and adherence, four of which with statistical significance. INTRODUCTION: This study aims to investigate the quality of detection and management of falls in the elderly population by general practitioners in the Netherlands, using the Assessing Care of Vulnerable Elders (ACOVE) quality indicators. METHODS: Community-dwelling persons aged 70 years or above, registered in participating general practices, were asked to fill in a questionnaire designed to determine general practitioner (GP) adherence to fall-related indicators. We used logistic regression to estimate the association between increased risk for functional decline-quantified by the Identification of Seniors At Risk for Primary Care score-and adherence. We then cross-validated the self-reported falls with medical records. RESULTS: Of the 950 elders responding to our questionnaire, only 10.6 % reported that their GP proactively asked them about falls. Of the 160 patients who reported two or more falls, or one fall for which they visited the GP, only 23.1 % had fall documentation in their records. Adherence ranged between 13.6 and 48.6 %. There was a significant positive association between the ISAR-PC scores and adherence in four QIs. Documentation of falls was highest (36.7 %) in patients whom the GP had proactively asked about falls. CONCLUSION: Based on patient self-reports, adherence to the ACOVE fall-related indicators was poor, suggesting that the quality of evaluation and management of falls in community-dwelling older persons in the Netherlands is poor. The documentation of falls and fall-related risk factors was also poor. However, for most QIs, adherence to them increased with the increase in the risk of functional decline.
- Published
- 2016
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