Experienced general practitioners’ and practice nurses’ views on the older-person health assessment forms
Eleanor K. L. Mitchell
A C and Angelo D’Amore A B
A School of Rural Health, Monash University, Bairnsdale, Vic. 3875, Australia.
B Eastern Victoria General Practice Training, Churchill, Vic. 3842, Australia.
C Corresponding author. Email: eleanor.mitchell@monash.edu
Australian Health Review 45(5) 647-653 https://doi.org/10.1071/AH20343
Submitted: 30 November 2020 Accepted: 25 April 2021 Published: 24 June 2021
Abstract
Objective Health assessments (HAs) are available annually for community-dwelling older people: the 75+HA for non-Indigenous Australians aged ≥75 years and the 55+IHA for Indigenous Australians aged ≥55 years. Medicare requires general practitioners (GPs) to cover the items within the relevant HA form. This study explored the views of experienced GPs and practice nurses (PNs) towards the older-person HA forms.
Methods Thirty-nine experienced GPs and PNs responded to an online questionnaire.
Results In this study, experienced GPs and PNs suggested that current items within the 75+HA Medicare-provided guideline form need reviewing, such as those relating to psychological function, medication and exercise and falls. There were also recommendations to consider including items consistently across both the 55+IHA and 75+HA and to include new items, such as personal alarms, loneliness, support networks, spiritual health, musculoskeletal diseases, whether other screening is up to date and future planning. Many parts of the HA were deemed irrelevant or condescending to ‘well’ older Australians, so should be optional. Healthcare professionals also requested reintroducing conducting the HA at the community-dwelling patient’s home. User-friendly integrated forms would improve healthcare professionals’ time management and provide better communication with patients and carers, and create greater opportunities for multidisciplinary referral processes, as well as provide linkages to MyAgedCare and myHealthRecord.
Conclusion Capturing the views of healthcare professionals towards older-person HA forms generated suggested improvements. The adoption of these suggestions would elicit more holistic health information for older Australians.
What is known about the topic? Annual HAs are available for older Australians (75+HAs and 55+IHAs). Medicare requires GPs cover items within their prescribed HA form. The 75+HAs and 55+IHAs allow for the monitoring of health problems specific to community-dwelling older people, which may be difficult to address in the time frames of a standard GP consultation; however, there is very little research on the experiences of health professionals regarding the conditions required to be assessed within the HAs.
What does this paper add? This study examined the views of experienced GPs and PNs to identify potential changes to the current procedures. Capturing the views of healthcare professionals towards older-person HA forms generated important suggested improvements, such as reviewing psychological function, medication, exercise and falls items. There were recommendations to include items across both the 55+IHA and 75+HA and new items, such as personal alarms, loneliness, support networks, spiritual health, musculoskeletal diseases assessments, future planning and whether the patient’s screening is up to date.
What are the implications for practitioners? The experienced GPs and PNs in this study suggested significant additions and revisions to the current HA forms. The incorporation of these suggestions should lead to permanent modifications of the current forms to make them more relevant and appropriate for older Australians, but the challenge for implementation is how these additional items would be funded.
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