Institution: | 1. Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands;2. The Dutch Council for Health and Society (Raad voor Volksgezondheid en Samenleving, RVS), The Hague, The Netherlands;3. Radboud University Medical Center, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands;4. Department of Geriatrics, Radboud University Medical Center, Nijmegen, The Netherlands |
Abstract: | Objective: To assess the impact of patient characteristics, patient-professional engagement, communication and context on the probability that healthcare professionals will discuss goals or priorities with older patients. Design: Secondary analysis of cross-sectional data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults. Setting: 11 western countries. Subjects: Community-dwelling adults, aged 55 or older. Main outcome measure: Assessment of goals and priorities. Results: The final sample size consisted of 17,222 respondents, 54% of whom reported an assessment of their goals and priorities (AGP) by healthcare professionals. In logistic regression model 1, which was used to analyse the entire population, the determinants found to have moderate to large effects on the likelihood of AGP were information exchange on stress, diet or exercise, or both. Country (living in Sweden) and continuity of care (no regular professional or organisation) had moderate to large negative effects on the likelihood of AGP. In model 2, which focussed on respondents who experienced continuity of care, country and information exchange on stress and lifestyle were the main determinants of AGP, with comparable odds ratios to model 1. Furthermore, a professional asking questions also increased the likelihood of AGP. Conclusions: Continuity of care and information exchange is associated with a higher probability of AGP, while people living in Sweden are less likely to experience these assessments. Further study is required to determine whether increasing information exchange and professionals asking more questions may improve goal setting with older patients. |