[The quest for adequate health care for the elderly: literature review and the application of an instrument for early detection and prediction of diseases]

Abstract

The increase in the elderly population demands changes in health care models by policymakers to deal with the substantial cost increase This article addresses patient access flow and the definition of priorities in an outpatient unit. A short questionnaire (8 questions) was used to assess enrollment and ranking of the elderly at risk of repeated hospital admissions, considered as a proxy for frailty. In a sample of 360 individuals, 75.8% of the elderly population was classified as "low risk". However, approximately 11% of the sample was considered to be at "medium" or "high" risk of becoming ill and requiring intensive use of health services. Our findings corroborate the usefulness (for promoting an effective health system for the elderly) of the proposed questionnaire as a tool to classify the elderly in different "frailty groups", using a hierarchic definition of vulnerability. The proposed ranking procedure can help adjust the portal of entry into the system, as used thus far in most Brazilian health facilities. The article concludes by suggesting that the validity of the method be tested in a prospective study.