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Preventive care for the elderly. Do family physicians comply with recommendations of the Canadian Task Force on Preventive Health Care?

OBJECTIVE
To assess to what extent family physicians perform the maneuvers for elderly patients recommended by the Canadian Task Force on Preventive Health Care (CTF), and to compare physicians' performance among patients who had structured periodic health examinations with performance among those who did not.


DESIGN
Retrospective chart audit.


SETTING
Family practice unit in a secondary care, university-affiliated hospital in Toronto, Ont.


PARTICIPANTS
Records of 136 community-dwelling patients aged 70 and older. Of 340 randomly selected charts, 108 were excluded and 51 were inaccessible; 100 had had PHEs, and a random sample of 36 who had attended the clinic three or more times was chosen from the remaining 81 [corrected].


MAIN OUTCOME MEASURES
Proportion of patients who received the recommended screening maneuvers.


RESULTS
Charts were audited for 100 patients who had structured periodic health examinations and 36 who did not but who attended the clinic three or more times during an 18-month period. Screening rates among patients who had structured examinations ranged from 28% of patients screened for hearing impairment to 100% screened for hypertension. Patients who did not have structured examinations were significantly less likely to receive screening maneuvers.


CONCLUSIONS
Screening rates were below desirable levels in patients older than 70 years. Screening during structured health examinations seems to be more effective than opportunistic screening for patients 70 and older.