Clinic-based primary care of frail older patients in California

Calvin H Hirsch, C. H. Winograd

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

We surveyed medical directors of primary care clinics in California to learn how those clinics cared for their frail older patients. Of 143 questionnaires sent, 127 (89%) were returned. A median of 30% of all patient encounters were with persons aged 65 or older, and a median of 20% of older patients were considered frail. A total of 20% of the clinics routinely provided house calls to homebound elderly patients. Of clinics involved in training medical students or physicians (teaching clinics), 70% had at least one physician with an interest in geriatrics, compared with 42% of nonteaching clinics (P < .005). For frail patients, 40% of the clinics routinely performed functional assessment, while 20% routinely did an interdisciplinary evaluation. Continuing education in geriatrics emerged as a significant independent correlate of both functional assessment and interdisciplinary evaluation. Among the 94 clinics with a standard appointment length for the history and physical examination, only 11 (12%) allotted more than 60 minutes for frail patients. The data suggest that certain geriatric approaches are being incorporated into clinic-based primary care in California but do not provide insight into their content or clinical effects.

Original languageEnglish (US)
Pages (from-to)385-391
Number of pages7
JournalWestern Journal of Medicine
Volume156
Issue number4
StatePublished - 1992

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Keywords

  • CLINIC- BASED GERIATRICS
  • ELDERLY PATIENT CARE
  • FRAIL OLDER PATIENTS
  • GERIATRIC MEDICINE

ASJC Scopus subject areas

  • Medicine(all)

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