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D in Hospital Administration
Topic The Role of Primary Health Care Centers in Providing Comprehensive Care for the Elderly in Kingdom of Saudi Arabia
by Mohammed Saeed Aowda
Under the supervision of Dr. Varanasi Madhusudan Prasad
Synopsis Checklist Introduction 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 The Backdrop Review of Literature Gaps in the existing literature Research questions The Problem Objectives Hypotheses Research Methodology 8.1 8.2 8.3 8.4 8.4.2 8.5 9.0 Scope of The Study Sample The Period of the Study Collection of Data 8.4.1 Primary Data Secondary Data
Limitations of the Study Chapter I : Introduction Chapter II: Literature Survey Chapter III: Research Methodology Chapter IV: Statistical Analysis Chapter V: Discussion of Results Chapter VI: Conclusion and Recommendations
Appendix I: Questionnaire or Research Instrument Appendix II: Theoretical Nuances, Models, Formulas etc. Appendix III: Business Environment - Industry Forces, Laws, Rules, Procedures... References (Author, Title, Publisher, Edition, Year)
7% of the total population while it rose in 1990 to become a 4% (World Bank report in 1993. This increase in this age group which is established by some experts as "Risk Group" need special attention in the quality and dispensing method of health services provided to them. bathe or perform any of the other activities essential for independent living declining physical and mental capacities signal marked deterioration in the quality of life. the elderly are more likely to experience episodes of depression and melancholy. functional and social problems. Also. introverted.than they did at the beginning of this century. In 1982 the proportion of older persons was 2. a great deal of attention has been given to health care for the elderly in health care planning and delivery all over the world. 1. and more concerned about his health. The elderly are not a homogeneous group. will vary greatly and depend both on the nature of their illness and on their previous state of health. The elderly person is more susceptible to diseases such as bronchitis. people live about 20 years longer-on average. heart disease. Aging is a natural process that leads to a gradual deterioration of body functions. currently. This is commensurate . p. elderly persons receive a large share of health services expenditures that do younger individuals in the USA. For this reason. They rarely go to the services of the first row (primary health care centers). This is due to the fact that advances in the field of medicine have achieved great improvements to the treatment of many diseases associated with old age. our religion urged the need to care for the elderly whether from the Muslim family or non. This fact has very important implications for the type of services needed by the elderly and the appropriate means of delivering such services. tumors etc. both in terms of the types of services needed. dress. 201). The needs of the elderly who become unwell and require hospital admission. although in practice they do not need more than services of primary health care centers. As far as the religious and social aspect is concerned. For instance. Elderly persons usually fear the loss of the ability to walk. It is estimated that. therefore. diabetes. the senses and mental abilities get weaker.0 The Backdrop: The proportion of older persons in the world is increasing and the Kingdom of Saudi Arabia is not exception from this scenario. their mode of delivery. The elderly person grows more suspicious. Perhaps the most important change has occurred in mortality rate.Introduction It is a well known fact that the structure of the population in the world has changed very drastically during this century. but represent a spectrum of individuals ranging from those who are fit and able to lead an independent life to those with multiple medical. which causes wasting of more health resources at the time the countries are suffering from high cost of health services. and a drastic change in personality takes place.Muslims. It is remarkable that this age group (the elderly) and other groups tend to receive health services to the advanced health facilities (specialized hospitals) or the second row of health services (public hospitals). particularly among the elderly population. The health care system should respond to social change in order to meet people's expectations as well as to set and implement efficient health care plans. In addition to that. and the staff required to deliver them.
or do more specific differences exist by which they might be categorized? One of thought (Klinman et al. There is much left to be done regarding the channeling of such services and the coordination of efforts among the various sectors and levels of health care within the health care system. . 206) divides the elderly into groups solely by age. the ways in which they differ cause much confusion. There is difficulty in determining where to draw the line. It is also known that the age of a person not necessarily coincide with his physical functions. None of the models or policies adopted abroad can be applied completely in the Saudi setting. On this basis. p. Are the two differentiated only by chronological age. `1992. The elderly population lacks homogeneity. These differences could be attributed to economic. Many studies indicate that the symptoms of old age. There isn't a consensus of opinion regarding the definition of the aged person. Therefore. the regulations that govern their performance. The majority in the Islamic and Arab societies prefer this group leave with them at home or in vicinity so they look after them almost every day. mental or psychological can appear in any stage of life. 2. which is the focus of the present research. In the Kingdom of Saudi Arabia. p.with the social aspects. and the time at which old age begins. 1992. in the light of the current trends in the care for the elderly in various parts of the world. Thus. countries differ in varying degrees regarding their health policies towards the elderly. The present study is concerned with the role that is being played and that can be played by Primary Health Care centers (PHCCs) in the delivery of comprehensive care for the elderly in the Kingdom of Saudi Arabia. the establishment of primary health care centers in all villages and towns can play this role. The first part addresses some issues of the elderly. many researchers agree that old age is the stage of life at which physical and mental functions begin to deteriorate more clearly than in any other previous stage. however. some authors describe the 'young old' as those younger than 75 years of age and the 'old old' as those 75 years of age or elder. Even in the census and other population statistics. despite the great deal of attention that has been given to health care in the Kingdom of Saudi Arabia. For instance. Although many facts about the elderly are more or less universal. this category of the population does not receive any special attention in the sense that there are no special programs for the care of the elderly. mental capacities begin to change at the age of twenty. as well as the economic stability make the Saudi society rather unique. to preserve the optimal use of resources.0 Review of Literature This literature review falls into two major parts. but in practical terms. The field of health services in the Kingdome of Saudi Arabia has witnessed a tremendous development both in terms of quality and quantity. While it is clear that the 88-year-old person. the elderly are often placed under the age group '45 or more'. 15). Health care for the elderly has been part and parcel of the health care plans in the Kingdom. and the role they play in the care for the elderly. particularly regarding the issue of care for the elderly. the type of cultural setting and the type of family relations. The second part addresses the topic of primary health care centers. (Abdel Mohsen. whether physical. The socio-cultural factors unique to the Saudi society have to be taken into consideration. their needs and the types of health care that can be given to them. social or cultured factors. while others draw the line at 80 or 85 years of age.
This expanded definition of health may indicate that the major goal of preventive care in the elderly is compression of morbidity rather than prevention of disease. mental and social well being and not merely the absence of disease of infirmity. It should be noted here that the World Health Organization (WHO) defines health as a state of complete physical. the elderly group is taken to refer to male and female individuals beyond 60 years of age. Some experts (Klinkman et al. In this research. pp. It should be noted here that outpatient clinics are similar to primary health care centers found in Saudi Arabia.It should be noted that no line of division could be generalized across cultures. mental and social functioning of the chronically disabled elderly in the least restrictive environment and at the best functioning level attainable by the individual. Abrahams and Lamb (1988. therefore. Thus the goal of preventive health care in the elderly should be to maintain optimal function as well as to prevent biomedical diseases. p. and the potential benefits from preventive services for the elderly would be inherently be much smaller in magnitude than the potential benefits for younger persons. There are various factors that should be considered in this regard such as life expectancy and general patterns of health conditions in the whole population. because it establishes the boundaries for the discussion of appropriate health outcomes by which we can measure the value of health services. 207) describe health in old age as consisting of three related factors: 1 – The absence of disease. be a growing need for programs that combine both health care and social support services designed to maintain the physical. but also those most vulnerable to chronic disease and functional impairment and most at risk for long term care. the medical community has not yet agreed on the appropriate definition of health in the elderly. p. satisfaction with life. They also point out that outpatient clinics in their setting require further development and evaluation. They also propose that patient eligibility to high cost management should be limited to those who are most likely to benefit from this comprehensive and expensive form of care. our analysis of the benefits of preventive services will be limited to measuring differences in diseaserelated morbidity or mortality. They conclude that there will. (1991. The definition chosen is very important. Kramer et al. Because of the lack of agreement about the categorization of the elderly persons. This categorization is study different from the categorization in Saudi Arabia for instance. 1992. If we look at health as the presence or absence of disease. 53-54) report on the conclusions and recommendations of a conference on geriatric evaluation and management. 179) point out that the elderly group comprises not only high users of medical and hospital services. 2 – The maintenance of optimal function. and productivity. The second and third factors allow the inclusion of quality of life. in addition to other cultural and religious factors. 3 – The presence of an adequate support system. . They point out that the geriatric assessment includes a multidimensional interdisciplinary patient evaluation that leads to identification of patient problems and the development of a plan for resolving these problems.
through psychosocial assessment. and the effectiveness of discharge planning for those who return to their homes after hospitalization. Hedrick et al. affect/life satisfaction. . patient function. We shall come back to this point when we discuss the current techniques for evaluating PHC centers in the Kingdom of Saudi Arabia. p. satisfaction. 48-52) present a working group recommendations regarding the measuring of outcomes of care in geriatric evaluation and management units. pp. They discuss three aspects of social work. south and east Asia. pp. general health perceptions and comprehensive physical function. The main significance of the present study lies in the fact that it tries to utilize already existing health facilities to provide better services instead of establishing new facilities. their article examines the extent to which elderly people most in need receive social services. 291) present an evaluation of social work discharge planning services for elderly people. such as numbers of diagnoses. (1992. Hengstler (1986. restricted actively days. They view planning as a complex and highly skilled task involving screening. access. This study will focus on various countries of Middle East. and gulf countries. 4. secondary and tertiary health services in the Kingdom. Other outcomes. social function and satisfaction with care. They also suggest measuring cognitive function. the extent to which the discharge planning performed is a professional task. That group suggested measures for physical health included survival. Specifically. and coordination of an interdisciplinary team of providers. Europe. Particularly the following: Physical services. caregiver burden and costs.They suggest that the most important outcomes to assess in any program for geriatric care are mortality. but also the better management of health services in general. Oktay et al. The fact that PHCCs are wide-spread and can reach and be reached easily by citizens makes them suitable locations for the provision of comprehensive care to the elderly.0 Research Questions: The present research is set to answer the following questions: 1 – What is the type and quality of services currently provided by the PHCCs to the elderly? 2 – To what extent can PHCCs be utilized to provide comprehensive care for the elderly?. complexity and outcome. provision of counseling and education.0 Gaps in existing literature: The present literature is merely based on experiments carried out in few countries. improved function and lower costs. (1991. 3. number of medications and level of care placement may be important to assess but are process measures which presumably mediate the desired final outcomes of reduced mortality. The direct result of this proposition would be not only the care for the elderly. and the better coordination of primary. 15–16) believes that care of the elderly should be oriented towards early identification of high risk groups and reversal or arrest of disease and functional decline.
Diagnostic services. One of the criteria of evaluating any health care system in making available the suitable and comprehensive health care in a convenient way on equitable basis to the various geographical locations and the various age groups. Elderly people are not only treated like other individuals who use PHC services.- Psychiatric services. 201). The reason for this could lie in the type of health service provided by primary health care centers which may not be suitable to the needs of the elderly. of course is a great waste in resources and a clear mismanagement of health care. psychiatric and social problems disregarded. Every elderly person has one way or the other of utilizing tertiary health care directly even if his ailment can be handled in secondary or even primary levels. This expanding age group requires special attention in terms of the type of health care and their mode of delivery. It also lie in socio-cultural factors. psychiatrists. This. In 1990 the elderly become 4% of the population (World Bank. 3 – What are the facilities required by PHCCs in order to provide comprehensive care to the elderly? 4 – What is the staff requirement of PHCCs in order to provide comprehensive care to the elderly (physicians.0 The Problem: Health care service is expanding very rapidly in Saudi Arabia. The fact remains that primary health care can play a major role in providing health care to the elderly particularly at the preventive level. particularly the attention given to the elderly by their family members. The number of the elderly in the Kingdom of Saudi Arabia. those centers do not adopt any special policy or programs directed towards the elderly. Although the PHCCs are considered convenient and readily available sources of health care. Prognostic services. is increasing due to the development in health care. p.7% of the population. Social services. but also they are viewed from a somatic aspect with their psychological. the problem of the present study is the inadequacy of the services provided by PHCCs to the elderly population in the Kingdom of Saudi Arabia. 6. experience and position? 5. In fact. social workers. home nurses etc. Preventive medical services. their services to the elderly population are less than satisfactory.0 The Objectives: The goal of the study is to improve the health care services of the elderly population in Saudi Arabia. In 1982 the elderly were 2. Thus. multidisciplinary paramedical personnel. as it is generally the case all over the world. Under this broad goal. 1993.) 5 – Does the opinion of the PHCCs physicians regarding care for the elderly vary according to their age. the objectives of the present research . One can easily notice that elderly people utilize tertiary and secondary health care services more that primary health care.
e. The survey covers physicians in the PHCCs in Saudi Arabia. Comprehensive Care: The type of care that would include not only the somatic aspect of the individual. deserts and plains.are defining the role currently played by PHCCs in the delivery of comprehensive care to the elderly. mental and social aspects as well.3 The Period of Study: This study will focus on health care services for elderly in Kingdom of Saudi Arabia during last two decades. It involves an opinion survey of the physicians currently working in the PHCCs. 8.2 Sample : The study samples include all the study community i. Following are operational definitions of the key terms of the study: Primary Health Care: The type of health services provided through PHCCs as regulated and described by the Ministry of Health in the Kingdom of Saudi Arabia. 8. The community of study includes all doctors working in primary health care centers in the Kingdom. and focuses on the role PHCCs currently play in the care for the elderly. The Elderly Group: Male and female individuals 60 years of age and above.1 Scope of Study: The study is conducted on Primary Health Care Centers in Kingdom of Saudi Arabia. 7. Moreover it has terrain elevations. and the ways it can be improved. hospitals and specialty hospitals.0 Research Methodology: This study will be conducted in the Kingdom of Saudi Arabia which lies in west Asia. and the way they can be improved in order to provide an efficient and comprehensive care for such group. Its population of Saudi Arabia as of the April 2010 Census was 18707576 Saudi nationals and 8429401 non-nationals. It is a significant country among the gulf countries. This country is also distinguished by its urban as well as nomadic and rural life which includes various sects of the society. the number of doctors working in primary health care centers in Kingdom of Saudi Arabia. . 8.The actual needs of the elderly are not fulfilled in primary health care centers 2 – The primary health care centers can provide additional services apart from the materials that they have. It has a large number of primary health care centers. 3 – The primary health care centers can provide comprehensive services for the elderly by adding some privileges and resources 8.0 Hypotheses: This study will be carried out on the basis of few assumptions given below: 1 . but the psychological.
8.4.The actual services that can be provided for the elderly and the degree of its relevance. 201).Services provided to the elderly in the present time and the importance and the extent to which they are used.Services provided to the elderly in the present time and the importance and the extent to which they are used. c – The additional services that can be provided for the elderly by the current equipment in primary health centers.The actual services that can be provided for the elderly and the degree of its relevance 3 – The additional services that can be provided for the elderly by the current equipment in primary health centers 4 – The needs that can be provided to primary health care centers for providing quality services for older people 9.2 . In 1982 the proportion of older persons was 2.Secondary Data: This information will be collected from books. p. This will cover the following aspects: a .4. It is remarkable that this age group (the elderly) and other groups tend to receive health services to the advanced health facilities (specialized .8. The study will focus the following: 1 .7% of the total population while it rose in 1990 to become a 4% (World Bank report in 1993. 2 . magazines and publications of the Ministry of Health related with topic the research.0 Chapterization The Chapterization will be as under: Chapter I : Introduction The proportion of older persons in the world is increasing and the Kingdom of Saudi Arabia is not exception from this scenario. d – The needs that can be provided to primary health care centers for providing quality services for older people 8. b .1 Primary Data: Information will be collected through the questionnaire distributed to doctors working in primary health care centers in Saudi Arabia.5 Limitations of the Study: The community of study includes the working manpower Saudis and non-Saudis to improve the health care services of the elderly population in Saudi Arabia.4 Collection of Data: 8. This increase in this age group which is established by some experts as "Risk Group" need special attention in the quality and dispensing method of health services provided to them.
and focuses on the role PHCCs currently play in the care for the elderly.Muslims. in the light of the current trends in the care for the elderly in various parts of the world. which causes wasting of more health resources at the time the countries are suffering from high cost of health services. The study is conducted on Primary Health Care Centers in Kingdom of Saudi Arabia. Chapter III: Research Methodology This study will be conducted in the Kingdom of Saudi Arabia which lies in west Asia. The first part addresses some issues of the elderly. deserts and plains. the regulations that govern their performance. Its population of Saudi Arabia as of the April 2010 Census was 27136977: 18707576 Saudi nationals and 8429401 non-nationals. It has a large number of primary health care centers. their needs and the types of health care that can be given to them. although in practice they do not need more than services of primary health care centers. As far as the religious and social aspect is concerned. It falls into two major parts. The majority in the Islamic and Arab societies prefer this group leave with them at home or in vicinity so they look after them almost every day. to preserve the optimal use of resources. The second part addresses the topic of primary health care centers. Therefore. This country is also distinguished by its urban as well as nomadic and rural life which includes various sects of the society. This is commensurate with the social aspects. the establishment of primary health care centers in all villages and towns can play this Chapter II: Literature Survey The literature available on the subject will be reviewed.Kay Square "2" This method is used to determine the importance of the impact of some personal characteristics of the building such as age.hospitals) or the second row of health services (public hospitals). Chapter V: Discussion of Results The results of complete data analyzed by the descriptive and method Kay square “2” will be laid down after having discussed the pros and cons of various forms and trends of . and the way they can be improved in order to provide an efficient and comprehensive care for such group.Descriptive Statistics These descriptive statistics are used for information that is collected B . It involves an opinion survey of the physicians currently working in the PHCCs. Moreover it has terrain elevations. hospitals and specialty hospitals. and the role they play in the care for the elderly. our religion urged need to care for the elderly whether from the Muslim family or non. experience and position on their replies. They rarely go to the services of the first row (primary health care centers). It is a significant country among the gulf countries. The survey covers physicians in the PHCCs in Saudi Arabia. Chapter IV: Statistical Analysis The two methods that will be used to analyze the data are as follows: A .
These include the following programs: 1 – The Heat Support Project: This project has been in effect for a long time. 2 – The Unemployment Program: This program helps the elderly people by helping them find suitable jobs to spend their time and meet the necessities of life. During the two years 1976 and 1977. Bus service for the elderly are usually provided by local companies and it usually employs elderly drivers. 7 – Transportation Services: This program provides free transportation to the elderly. 50% of the inpatients are elderly persons. Some new trends suitable to the British society are adopted. this program served more than half a million elderly persons. The program subsidizes the heat and electric bills of the elderly. . The Elderly in the Italian Society: The elderly in the Italian society have various needs and problems. Its main aim is ensuring that the elderly receive adequate heat during the cold months of winter. Also. and day care hospitals. People above 60 years of age in the Italian hospitals are 17%. 5 – The Good Neighbor Program: This program works for the establishment of active groups that disseminate information regarding the elderly and urges the society and the various organizations to extend help and support to them. Each family is given 30 pounds a week. It is usually financed by the local authorities. comprehensive home care. 8 – Meals on Wheels: This program provides free meals for the elderly at their homes.health care for the elderly in some eastern and western societies along with the problems tackled and the services rendered to the elderly group in each of those societies such as: The Elderly in the British Society: The British society gives a great deal of attention to the elderly group. These include housing. Some of the programs designed for the elderly include housing. day-care centers. 3 – Insurance for the Elderly: This program regularized the insurance benefits of the elderly and follows up on the paper work and other insurance procedures on behalf of the elderly. financial assistance. health care. 4 – Mass Media Services: This program works for the production of media materials and programs to educate the society about the need of the elderly. 6 – Neighborhood Care: This program provides financial support to families that undertake care for the elderly neighbor. and instruct the elderly on how to take care of themselves.
There are three types of care for the elderly according to the French plan: home care. They offer educational activities as well as professional and sports functions. 3. The elderly in France are classified into healthy. . 270. home care. and medical treatment.S. are accepted in the day are centers. 2. day care in addition to other forms of care. Depending on their health status they are provided discounted health completely free health care.Medical services which include: . Other elderly persons are kept in their families as much as possible and financial as well as technical assistance are extended to them free of charge. These include financial assistance. they need the help of others around the house. Only those elderly persons who are not independent that is. Elderly persons who choose to stay with their families are provided with opportunities to participate in social functions. The day care centers are financial by the local authorities in collaboration with local private establishments. home care. . ill and disabled.A: The new trends for elderly care in America reflect the nature of the American society itself. 4.Social programs which include: . The Elderly in the U.preventive care through the social services section.health care through public health centers.health care and rehabilitation.health care through day care centers.The Elderly in Denmark: The elderly in Denmark enjoy a comprehensive care program based on the application of new techniques.social services and social welfare. That society is characterized by economic power and advanced technology. . . Day care centers extend their services to those elderly who do not have someone to help them at home. Some of the forms of care for the elderly in the American society include the following: 1. The Elderly in Hungary: .telephone contacts with the elderly by volunteers. and day care centers. third age clubs and restaurants. The Elderly in France: Care for the elderly in the French society is based on integrating the elderly with those who are younger. In order to encourage the elderly to remain in their families. financial assistance. some services are provided for them.000 elderly persons are provided with health services at home so whey don't have to go the hospital.Involving the elderly in voluntary services to spend their time and to help them feel their importance to society. It includes social services. semi healthy.Employment projects : There are establishment that work towards employment of the persons above 50 years of age.
the visiting physical therapist. 438-441) report on the Geriatric Institutions of Geneva. and the visiting physician. 3 – Complete housing for disabled elderly citizens. They state that these institutions constitute a 275-bed hospital. The Swiss Experience: Junod and Levy (1981. These institutions have the following three goals: 1 – To address the complex medical needs of the older patient. pp. and the visiting psychiatrist. and 80-bed extended care facility. The Elderly in Kuwait: The Kuwaiti law provided for extending assistance to elderly citizens. It includes visits by nurses. where they receive complete care and are visited by their families and friends. 4 – Home-for-the old: This service is provided to elderly couples who wish to lead an independent life but cannot afford it. The staff comprises over 50 physicians and psychiatrists. Some of the forms of care for the elderly in Hungary include the following: 1 – Home social care: This service is extended to the elderly who wish to stay at home. Care is extended to the elderly through a department affiliated to the Ministry of Health. which include the visiting social worker.In Hungary. 3 – Elderly homes: This service is provided to the elderly who choose to leave their families. physicians and healthy elderly people. . and to help them follow the mass media and practice their favorite sports. health care. 2 – To motivate the staff about the specific problems of the elderly and how to deal with them. and other daily needs by the state. free of charge. social workers. the state takes full responsibility for the welfare of the elderly. The family also plays an important role in that regard. 2 – Day care. which allows the elderly to spend the day in the center where he indulges in social activities and receives recreational and therapeutic services. and a large complement of social workers. multidisciplinary paramedical personnel. They are provided with social insurance. Some forms of care for the elderly in Kuwait include: 1 – Home care. and a large consultation service for ambulatory patients. Such persons are employed also in visiting other elderly in their homes. 3 – To promote awareness in the community of the complexity of problems associated with geriatric patients. 2 – Day care centers: This service is provided to the elderly with the aim of monitoring their health conditions.
Chapter VI: Conclusion and Recommendations: As the correct results will be accumulated to analyze the study and the opinion of previous studies on the topic of this research including the opinion of the researcher.Junod and Levy describe the model of geriatric health-care delivery developed and practiced in Geneva as "Integrated Medicine". diagnosis. the recommendations will be presented. It constitutes a step toward developing a health-care delivery system specifically adapted to the geriatric patient. but also a particular philosophy of management with objectives specifically adapted to their unique path physiologic. This is not simply a multidisciplinary approach to the multiple disorders of the elderly patients. and prognosis. . psychiatric and social needs. therapeutics. The model comprises preventive medicine.
Appendix I: Questionnaire or Research Instrument A QUESTIONNAIRE TO PHCC DIRECTORS ON THE ROLE OF PRIMARY HEALTH CARE CENTERS IN COMPREHENSIVE CARE FOR THE ELDERLY IN THE KINGDOM OF SAUDI ARABIA (A Research Project Proposal) By: MOHAMMED SAEED AOWDA Research Advisor: Dr. A major aim of this research is to propose ways and means for improving the type and quality of service provided to the elderly by primary health care centers. You are kindly requested to read the statements of the questionnaire very carefully and then "tick" the answers that represent your viewpoint. The topic of my research is "The Role of Primary Health Care Centers in Providing Comprehensive Care for the Elderly". Thank you for your cooperation. I am currently conducting a research project in partial fulfillment of the requirements of Ph. To achieve this aim the questionnaire in your hands has been designed to obtain your opinion regarding the current practices in primary health care centers and the means to improve them. D degree in health administration. Please note that an elderly person is taken to refer to a man or woman beyond 60 years of age. . The information collected in this questionnaire will be used only for the research purposes and will be kept confidential. Varanasi Madhusudan Prasad Dear PHCC Physician.
Health problems Mental problems Physical problems Psychological problems Social problems Frequent Sometimes Rare Never 9 – Indicate the following health problems for which elderly people may visit your center. do you think old patients reporting to your center complain about some special problems? Yea No 8 – Indicate the following health problems for which elderly people may visit your center according to their level of frequency.1 – Age: less than 30 30-39 40-50 more than 50 2 – What is your position in PHCC? (check one) Physician Medical director Other (specify ----------------------3 – How long have you been in this post: less than 3 years 3-5 years more than 5 years 4 – Do you keep any special records for elderly citizens in your service area? Yea No 5 – Approximately. according to the service provided (please check more than one service if applicable). what is the percentage of elderly patients to other patients that actually use the services in your center? [ ……………% ] 6 – Is there any program in your Health Center especially designed to meet the needs of the elderly? Yea No 7 – In your opinion. Health problems treatment diagnosis referral Follow up no service .
psychological service 4 – social service fully only partially not at all 14 – To what extent can your PHCC incorporate the following new services with its current facilities and resources. and if provided with new facilities and resources? (Choose 1. 2 or 3) 1 – fully 2 – only partially 3 – not at all .physical health service 2 – mental health service 3 . Service Mental services Physical services Psychological services Social services Others (specify) very important important unimportant 11 – Are all services indicated above in question 10 available at your center? All of them Some of them Non of them 12 – Specify the reasons (and their degree of importance) for the unavailability of such services at your PHCC Reason lack of trained staff irrelevance of such services to the elderly lack of necessary equipment lack of building facilities lack of cooperation of the part of elderly lack of cooperation on the part of family Others (specify) very important important Unimportant 13 – To what extent can your PHCC provide the following services depending on its current facilities and resources? Service 1.Mental problems Physical problems Psychological problems Social problems 10 – Indicate the degree of importance of each of the following services for the elderly.
additional technical staff 3. Canadian Medical Association Journal. G. 1– very important 3.hospital-PHCC service coordinator 7.New Service visiting nurse doctor-on-call emergency home service routine home service on-phone prognostic service physical therapy at PHCC home physical therapy psychiatric service social gatherings spare time activities social consultation health awareness lectures public seminars family consultation With existing facilities and resources With new facilities and resources 15– Determine the degree of importance of each of the following items in providing comprehensive service (including new services) to the elderly at your PHCC. An introduction to primary health care approaches in developing countries.. 144(10).important 4.visiting specialists 2. 4 . No 13. Developing Reliable Assessment in Case-Managed Geriatric Long Term Care programs QRB-June 1988. W. Lamb. R. London: Ross Institute Publication. M. and S..citizen-PHCC relations committee Others (specify) ********** References Abrahams.social workers 4.unimportant Degree of importance Service 1.sports and social activities supervisor 5. No.important to some extent 2. 1981.additional building facilities and equipment 6. Cost-containment and Financing the Long-term Care of the Elderly. (1991). JAGSAPRIL 1988-VOL.36. Effectiveness of three types of geriatric medical services: Lessons for geriatric psychiatric services. Cole. Graber A. Gill. and Patrick Vaughan.
. and M. Medicare 1986: Can Society afford quality physician care? Part 11. Macfarlane.. Mamon. Buzas. Rabins. Constructing Gerontological Curricula for Health Administration. Meehan: Research Strategies for Geriatric Evaluation and Management: Conference Summary and Recommendations. Home Care for the Elderly: Arch Intern Med. and M. Applegate. K.Vol. Health & Social Work.17. Paul Haber. P. Vol. 68. Rubenstein L. 151. Vincent Mor. Hengstler. D. . Ruffin.. Klinkman P. Steinwachs. Vol.. 40. and M.. and S. J. 2.. No. 1993. JAGS-SUP. The American Geriatric Society (JAGS-Sup) 39: 48S-52S. Roberts. (1992) Evaluating social work discharge planning services for elderly people: Access. December 1 Supplement Vol. Targeting Health Advocacy Efforts Toward the Older Population. Beard.4. P. A Criterion-Based Review of Preventive Health Care in The Elderly: Part 1. Vol. J. Vol. J. JAGS. 41 No. J. 1992 Kramer A. Dall. Vol. S. August 1989. Stewart D. World Development Report. Oktay. Health Bulletin. Nancy Barrand. Salloway J. The Journal of Administration Education 11:1. Bone. L. The Roles of General and Geriatric Medicine in the Provision of Acute Medical Care for Elderly Patients.. Winter 1993. Mehr. Geriatrics. 34. D. J. Cancer. 7. Journal of the American Geriatrics Society. L. Prevention of Mental Disorder in the Elderly: Current Perspectives and Future Prospects. No. World Bank. Burns. Vol. 1991 Moxley.Hedrick S. William Scanlon. Jeffery Metter. 39. I. Perceptions of Case Management Services for Elderly People. No. 24. Richard Deyo. October 1986. March 1991. . M.. Counte. Kenneth James. complexity.V.. M. and outcome. W. L. 10. Clandon. No. 1991. Lennox. William Wissert. Eeyo. July 1992. Oxford University Press. R. What is Geriatrics? The Swiss Experience. and Mark Williams. Fahey. Working Group Recommendations: Measuring and Management Units. Junod. October 1981. Zazove. Steel. D. K. 1991. 10. Journal of Family Practice. and G. 50/3 May 1992.. and G. Levy. Health and Social Work.
:Arabic References ابا الخيل راشد ، الشيخوخة ومراكز العناية بالمسنين في العالم ، المملكة العربية السعودية ، 1991م . الفحيص بهجت ، العناية بكبار السن وطب الشيخوخة ، المجلة الثقافية ، العدد 92 ، يوليو 3991م . . عبد الهادي حامد ، اتجاهات حديثة في رعاية المسنين : دراسات واقعية في المجتمعات المعاصرة ، أوراق عمل وتقارير الندوة العلمية لرعاية المسنين بالدول العربية الخليجية ، المنامة 2891م . خلف أحمد خلف ، كبار السن والمدنية ـ رعاية المسنين في المجتمعات الحديثة ) قضايا واتجاهات ( المكتب التنفيذي لمجلس وزراء العمل والشؤون الجتماعية بدول مجلس التعاون لدول الخليخ العربية ، سلسلة الدراسات الجتماعية والعمالية )81( يناير 2991م . عبد المحسن عبد الحميد ، الخدمة الجتماعية في مجال رعاية المسنين ، الطبعة الثانية ـ القاهرة ، 2991م . المزروع يعقوب ، دليل العاملين في الرعاية الصحية الولية ، وزارة الصحة ، المملكة العربية السعودية ، 1991م .
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