Estratificación de la población mayor de 65 años en grupos de riesgo clínico: características y valoración enfermera / Stratification of clinical risk groups in a population over 65 years: Features and nursing assessment

OBJETIVO: Analizar las características de la población mayor de 65 años atendida en un Área Básica de Salud según la clasificación de Clinical Risk Groups (CRG, «Grupos de Riesgo Clínico») y la valoración de los test geriátricos realizados por la enfermera en relación con la complejidad que presentan. MÉTODO: Estudio observacional, descriptivo transversal, realizado sobre la población mayor de 65 años atendidos en un Área Básica de Salud. Se recogieron variables sociodemográficas, clasificación CRG, enfermedades (CIE-10), actividad asistencial, valoración geriátrica y actividades preventivas. Se utilizó la clasificación CRG como instrumento de medida. La recogida de datos se realizó mediante la historia clínica informatizada (e-CAP) de Atención Primaria. RESULTADOS: Población mayor de 65 años: 3.219 personas; atendidas a domicilio 130 (4%), y en institución residencial, 92 (2,85%). La población se agrupó en: CRG 1-2: 83 (2,5%); CRG 3: 62 (2%); CRG 4: 99 (3%); CRG 5: 537 (17%); CRG 6: 2077 (64,5%); CRG 7: 276 (8,6%); CRG 8: 61 (2%); CRG 9: 14 (0,4%). Las enfermedades crónicas más frecuentes fueron: 69,12% HTA, 24,94% DM, 19,51% depresión y 11,09% insuficiencia renal. Se analizaron los grupos 6-7-8, que incluían 2.414 personas (75%). De las personas con CRG 6-7-8, solamente 570 (24%) tenían test geriátricos realizados por la enfermera. La media de personas asignadas por enfermera para CRG 6-7-8 fue de 302. CONCLUSIONES: En la práctica clínica, la incorporación de sistemas de clasificación como los CRG conjuntamente con el uso de las nuevas tecnologías de la información y la comunicación permite incorporar modelos predictivos de necesidades sanitarias e impulsar acciones proactivas por parte de enfermería y del equipo para prevenir complicaciones de enfermedades, y mejorar la eficiencia tanto en la utilización de servicios como en la atención a la complejidad

OBJECTIVE: To analyze the characteristics of the population over 65 years served in a Basic Health Area, according to the Clinical Risk Group (CRG) classification and geriatric assessment test performed by the nurse in relation to their complexity. METHODS: A descriptive, cross-sectional and observational prevalence study was conducted on the population over 65 years served in a Basic Health Area. The variables collected were: socio-demographic, CRG classification, diseases (ICD-10), healthcare activity, geriatric assessment, and preventive activities. The CRG classification was used as a measurement tool. Data was collected from the Primary Care computerized clinical history (e-CAP). RESULTS: Population over 65 years: 3,219 people; served at home, 130 (4%), and in residential institutions, 92 (2.85%). The population was grouped into: CRG 1-2: 83 (2.5%); CRG 3: 62 (2%); CRG 4: 99 (3%); CRG 5: 537 (17%); CRG 6: 2,077 (64.5%); CRG 7: 276 (8.6%); CRG 8: 61 (2%); CRG 9: 14 (0.4%). Most frequent chronic diseases: 69.12% AHT; 24.94% DM; 19.51% depression; 11.09% kidney failure. The groups 6-7-8 that were analyzed included 2,414 people (75%). Of those within CRG 6-7-8, only 570 (24%) had tests carried out by the geriatric nurse. The mean number of individuals assigned by a nurse for CRG 6-7-8 was 302. CONCLUSIONS: The introduction of classification systems in clinical practice, such as the CRG, along with the use of the new information and communication technologies, helps to incorporate predictive models of health needs. It also promotes proactive actions by nurses and the team to prevent complications of diseases, as well as improving efficiency in the use of services and in care of the complex patients

[Stratification of clinical risk groups in a population over 65 years: features and nursing assessment]. / Estratificación de la población mayor de 65 años en grupos de riesgo clínico: características y valoración enfermera.

OBJECTIVE: To analyze the characteristics of the population over 65 years served in a Basic Health Area, according to the Clinical Risk Group (CRG) classification and geriatric assessment test performed by the nurse in relation to their complexity. METHODS: A descriptive, cross-sectional and observational prevalence study was conducted on the population over 65 years served in a Basic Health Area. The variables collected were: socio-demographic, CRG classification, diseases (ICD-10), healthcare activity, geriatric assessment, and preventive activities. The CRG classification was used as a measurement tool. Data was collected from the Primary Care computerized clinical history (e-CAP). RESULTS: Population over 65 years: 3,219 people; served at home, 130 (4%), and in residential institutions, 92 (2.85%). The population was grouped into: CRG 1-2: 83 (2.5%); CRG 3: 62 (2%); CRG 4: 99 (3%); CRG 5: 537 (17%); CRG 6: 2,077 (64.5%); CRG 7: 276 (8.6%); CRG 8: 61 (2%); CRG 9: 14 (0.4%). Most frequent chronic diseases: 69.12% AHT; 24.94% DM; 19.51% depression; 11.09% kidney failure. The groups 6-7-8 that were analyzed included 2,414 people (75%). Of those within CRG 6-7-8, only 570 (24%) had tests carried out by the geriatric nurse. The mean number of individuals assigned by a nurse for CRG 6-7-8 was 302. CONCLUSIONS: The introduction of classification systems in clinical practice, such as the CRG, along with the use of the new information and communication technologies, helps to incorporate predictive models of health needs. It also promotes proactive actions by nurses and the team to prevent complications of diseases, as well as improving efficiency in the use of services and in care of the complex patients.