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Priority setting in general practice: health priorities of older patients differ from treatment priorities of their physicians.

Abstract：

AIM:To ascertain health priorities of older patients and treatment priorities of their general practitioners (GP) on the basis of a geriatric assessment and to determine the agreement between these priorities. METHODS:The study included a sample of 9 general practitioners in Hannover, Germany, and a stratified sample of 35 patients (2-5 patients per practice, 18 female, average age 77.7 years). Patients were given a geriatric assessment using the Standardized Assessment for Elderly Patients in Primary Care (STEP) to gain an overview of their health and everyday problems. On the basis of these results, patients and their physicians independently rated the importance of each problem disclosed by the assessment. Whereas patients assessed the importance for their everyday lives, physicians assessed the importance for patients' medical care and patients' everyday lives. RESULTS:Each patient had a mean ± standard deviation of 18 ± 9.2 health problems. Thirty five patients disclosed a total of 634 problems; 537 (85%) were rated by patients and physicians. Of these 537 problems, 332 (62%) were rated by patients and 334 (62%) by physicians as important for patients' everyday lives. In addition, 294 (55%) were rated by physicians as important for patients' medical care. Although these proportions of important problems were similar between patients and physicians, there was little overlap in the specific problems that each group considered important. The chance-corrected agreement (Cohen κ) between patients and physicians on the importance of problems for patients' lives was low (κ=0.23). Likewise, patients and physicians disagreed on the problems that physicians considered important for patients' medical care (κ=0.18, P<0.001 for each). CONCLUSION:The low agreement on health and treatment priorities between patients and physicians necessitates better communication between the two parties to strengthen mutual understanding.

journal_name

Croat Med J

journal_title

Croatian medical journal

authors

Voigt I,Wrede J,Diederichs-Egidi H,Dierks ML,Junius-Walker U

doi

10.3325/cmj.2010.51.483

subject

Has Abstract

pub_date

2010-12-01 00:00:00

pages

483-92

issue

eissn

0353-9504

issn

1332-8166

journal_volume

pub_type

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Priority setting in general practice: health priorities of older patients differ from treatment priorities of their physicians.