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 H ealth Care (CTE), and to compare physicians' performance among patients who had structured periodic health examinations with performance among those w ho did not. DESIGN Retrospective chart audit. SETTING Family practice unit in a secondary care, university-affiliate hosp ital 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 attended the clinic three or more times. A random sa mple of 36 was chosen from the remaining 81. MAIN OUTCOME MEASURES Proportion of patients who received the recommended s creening maneuvers. RESULTS Charts were audited for 100 patients who had structured periodic he alth examinations and 36 who did not but who attended the clinic three or m ore times during an 18-month period. Screening rates among patients who had structured examinations ranged from 28% of patients screened for hearing i mpairment to 100% screened for hypertension. Patients who did not have stru ctured examinations were significantly less likely to receive screening man euvers. CONCLUSIONS Screening rates were below desirable levels in patients older t han 70 years. Screening during structured health examinations seems to be m ore effective than opportunistic screening for patients 70 and older.