English System Failing -- MEDICA - World Forum for Medicine

English System Failing

The large-scale independent study of quality of care involved 8,688 people aged 50 and over and looked at 13 different health conditions. Overall, only 62 percent of the care recommended for older adults is actually received, conclude the authors.

The research team studied whether effective healthcare interventions were received by people aged 50 and over with serious health conditions. They used questionnaires, face to face interviews and medical-panel endorsed quality of care indicators, for both public and privately provided care, as part of the English Longitudinal Study of Aging (ELSA).

Results showed huge variations by health condition in whether or not people with particular health conditions received the appropriate intervention or care they should. Overall, there were 19,082 opportunities for care to be delivered to people, but actual care was only given in 11,911 (62 percent) of those opportunities.

Substantially more care was provided for general medical conditions (74 percent) than for geriatric conditions (57 percent), the latter comprising falls, osteoarthritis, urinary incontinence, vision problems (cataract), hearing problems, and osteoporosis.

Interestingly, medical conditions that general practitioners receive extra rewards for dealing with under the Quality and Outcomes Framework of their current contract were attended to better. In 75 percent of such cases, people did get the right treatment, but only 58 percent of correct treatment was received by people with conditions not covered by the contract.

Receipt of care was also substantially higher for screening and preventative care (80 percent) than for treatment and follow-up care (64 percent), which in turn was higher than diagnostic care (60 percent). Worryingly, conditions associated with disability and frailty had the largest shortfalls in terms of the care that people were not receiving but should have been.

MEDICA.de; Source: BMJ-British Medical Journal