title: Vulnerable older people in the community: relationship between the Vulnerable Elders Survey and health service use.
abstract: OBJECTIVE
  The Vulnerable Elders Survey (VES), a recently developed screening tool for at-risk older people in the community, has been validated in the United States. This study evaluated its profile in older Irish people. It assessed whether those categorized as vulnerable according to the VES were likely to use health services more frequently than others.
  
  
  METHODS
  Nationally representative cross-sectional interviews.
  
  
  METHODS
  Private homes in the community.
  
  
  METHODS
  Randomly selected older people (aged > or = 65) (N=2,033; 68% response).
  
  
  METHODS
  Interviews included the 13-item VES and questions on health service use.
  
  
  RESULTS
  The proportion scoring as vulnerable was identical to the U.S. sample (32.1% vs 32.3%). At the community healthcare level, participants categorized as vulnerable visited their primary care physician more frequently (mean visits 6.7 vs 4.0, P<.001), had more home-based public health nurse visits (29% vs 5%, P<.001), and were more likely to have had preventive influenza vaccinations (81% vs 72%, P<.001) in the previous year. More-vulnerable older adults did not differ on assessment of blood pressure (97% vs 96%), cholesterol (82% vs 85%), or receipt of smoking advice (66% vs 52%). Vulnerable participants were more likely to have used emergency department (17% vs 8%, P<.05), inpatient (21% vs 12%, P<.05), and outpatient (28% vs 21%, P<.05) hospital services. Fourteen percent of those categorized as vulnerable had zero or one visit to their family physician in the previous year.
  
  
  CONCLUSIONS
  This study provides further evidence, from a different healthcare system, of the potential of the VES to differentiate more-vulnerable older people. Prospective studies are needed to assess use of the VES as a clinical decision aid for community professionals such as family physicians and public health nurses.
authors.affiliation: Division of Population Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland. hmcgee@rcsi.ie
authors.forename: Hannah M
authors.initials: HM
authors.lastname: McGee
authors.forename: Ann
authors.initials: A
authors.lastname: O'Hanlon
authors.forename: Maja
authors.initials: M
authors.lastname: Barker
authors.forename: Anne
authors.initials: A
authors.lastname: Hickey
authors.forename: Anthony
authors.initials: A
authors.lastname: Montgomery
authors.forename: Ronán
authors.initials: R
authors.lastname: Conroy
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011379:Prognosis; D019984:Quality Indicators, Health Care; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States; D035862:Vulnerable Populations / Q000706:statistics & numerical data*