Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people’s perceptionsKay Price A C , Karen Grimmer B and Jan Foot B
A Safety and Quality in Health Research Group, Sansom Institute for Health Research, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA 5001, Australia.
B International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Email: email@example.com
C Corresponding author. Email: firstname.lastname@example.org
Australian Health Review 41(6) 606-612 https://doi.org/10.1071/AH15243
Submitted: 22 December 2015 Accepted: 28 September 2016 Published: 18 November 2016
Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens.
Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach.
Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA.
Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require.
What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people’s health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging.
What does this paper add? There is scant, if any, attention in the literature to the views of consumers who have completed a 75+HA, especially with regard to whether this opportunity is conducted with a person-centred mindset. This paper addresses this gap. Even after participating in the 75+HA, most participants were unclear as to the purpose of the assessment, what information had been recorded and what would happen from any concerns identified in the assessment. Comments about the 75+HA included that it did not ask people about their goals and what comprised their functionality to ensure their independent living.
What are the implications for practitioners? A person-centred approach requires active collaboration between primary health professionals and older people who are living the process of, and planning for, aging-in-place. Assessments like the 75+HA can assist in identifying whether older people may be experiencing early signs of functional decline, even if older people self-report living without problems in their home. Practitioners need to ask questions of older people and respond to what they say with a person-centred mindset.
References Australian Commission on Safety and Quality in Health Care. The Australian Charter of Healthcare Rights. Sydney: ACSQHC; 2009. Available at: https://www.safetyandquality.gov.au/publications/australian-charter-of-healthcare-rights-the/ [verified 24 October 2016].
 Australian Commission on Safety and Quality in Health Care. Australian Safety and Quality Framework for Health Care. Sydney: ACSQHC; 2010. Available at: https://www.safetyandquality.gov.au/national-priorities/australian-safety-and-quality-framework-for-health-care/ [verified 24 October 2016].
 Australian Commission on Safety and Quality in Health Care. The National Safety and Quality Health Service (NSQHS) Standards. Sydney: ACSQHC; 2015. Available at: https://www.safetyandquality.gov.au/our-work/accreditation-and-the-nsqhs-standards/ [verified 24 October 2016].
 Australian Commission on Safety and Quality in Health Care. Patient centred care: improving quality and safety through partnerships with patients and consumers. Sydney: ACSQHC; 2011. Available at: http://www.safetyandquality.gov.au/wp-content/uploads/2012/03/PCC_Paper_ August.pdf [verified 19 June 2016].
 Vasunilashorn S, Steinman BA, Liebig PS, Pynoos J. Aging in place: evolution of a research topic whose time has come. J Aging Res 2012; 2012 120952
| Aging in place: evolution of a research topic whose time has come.CrossRef |
 Department of Health. Health assessment for people aged 75 years and older. 2014. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_75andolder [verified 19 June 2016].
 Spillman M, Kimber D, Cheffins T. Patient views of over 75 years health assessments in general practice. Aust J Adv Nurs 2012; 29 5–10.
 Hamirudin AH, Ghosh A, Charlton K, Bonney A, Walton K. Trends in uptake of the 75+ health assessment in Australia: a decade of evaluation. Aust J Primary Health 2015; 21 423–8.
| Trends in uptake of the 75+ health assessment in Australia: a decade of evaluation.CrossRef |
 Newbury J, Marley J. 75+ health assessments. Aust Fam Physician 2001; 30 82–7.
| 1:STN:280:DC%2BD3M7ktFGgtw%3D%3D&md5=6665a6a1ec772153227723c8b65507c8CAS |
 Beaton K, McEvoy C, Grimmer K. Identifying indicators of early functional decline in community-dwelling older people: a review. Geriatrics Gerontology Intern 2014; 15 133–40.
| Identifying indicators of early functional decline in community-dwelling older people: a review.CrossRef |
 Grimmer K, Kennedy K, Milanese S, Price K, Kay D. The Australian 75+ Health Assessment: could it detect early functional decline better? Aust Health Rev 2015; 40 69–77.
| The Australian 75+ Health Assessment: could it detect early functional decline better?CrossRef |
 Grimmer K, Kay D, Foot J, Pastakia K. Consumer views about ageing-in-place. Clinical Intervent Aging 2015; 10 1–9.
 Sandelowski M. Focus on research methods – whatever happened to qualitative description? Res Nurs Health 2000; 23 334–40.
| Focus on research methods – whatever happened to qualitative description?CrossRef | 1:STN:280:DC%2BD3cvhsFCmtw%3D%3D&md5=e6ea8c7a58fe52f306ecf7ba7994f3a0CAS |
 Patton M. Qualitative research and evaluation methods. Sage: Thousand Oaks; 2002.
 Australian Bureau of Statistics. Socio-Economic Indexes for Areas (SEIFA). Canberra: ABS; 2013. Available at: http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa?opendocument&navpos=260 [verified 24 October 2016].
 Carer Recognition Act 2010. Australian Government Federal Registrar of Legislation. Available at: https://www.legislation.gov.au/Details/C2010A00123 [verified 2 November 2016].
 Australian Government. Ageing and aged care. Why is aged care changing? 2016. Available at: https://www.dss.gov.au/ageing-and-aged-care-aged-care-reform/why-is-aged-care-changing [verified 19 June 2016].
 Australian Institute of Health and Welfare. Australia’s health 2014. How healthy are we? 2016. Available at: http://www.aihw.gov.au/australias-health/2014/how-healthy/ [verified 19 June 2016].
 Price K. Debating the influence of self-reports by people living with chronic disease on healthy ageing and longevity. Annals NY Academy Sci 2007; 1114 144–53.
 Edvardsson D, Innes A. Measuring person-centred care: a critical comparative review of published tools. Gerontologist 2010; 50 834–46.
| Measuring person-centred care: a critical comparative review of published tools.CrossRef |