To enhance the proactive involvement of elders living in the community in maintaining their health and to increase their family physicians’ knowledge and awareness of the subject, ESHEL and Maccabi Healthcare Services initiated an experimental program called “Health Passport”. The program included elements relating to health maintenance for the elderly: flu inoculations; testing and treatment for hypertension; vision and hearing tests; diet and physical exercise; and fall prevention counseling. During the experimental program, which lasted three years, the elderly came for regular, scheduled check-ups with their family physicians to monitor their state of health. The program also included lectures, participation in discussion groups about correct behavior regarding various aspects of the program, participation for three months in a physical exercise group, and early detection tests for vision and hearing disorders. The physicians participating in the program attended lectures and received instructive written materials throughout the period the program was implemented.
The program was evaluated by a study that examined its development, implementation, successes and obstacles, and provided regular feedback to Maccabi and ESHEL. The study also sought to examine changes in the patterns of involvement and activity of family physicians participating in the program and the changes among the elderly who took part. To this end, the study monitored the participants, elderly non-participants in the care of participating physicians, and a control group of elderly non-participants in the care of non-participating physicians, over a period of two-and-a-half years.
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An important finding is that the percentage of elderly participants who underwent testing for the early detection of sensory functioning disorders and who were inoculated against the flu increased following the program. Among non-participating elderly patients whose family physicians were participating, the percentage of those undergoing early detection tests and receiving inoculations against the flu also increased. In contrast, there was no significant change in these areas within the control group.
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The findings suggest that the change among participating physicians was beneficial to elderly patients who did not themselves participate in the program. Such a program evidently does therefore contribute to improvements in the health maintenance patterns of elderly people and is particularly helpful in improving the practices of family physicians in this regard.
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Despite the progress made, a significant percentage of elderly people in the control group did not undergo early detection tests. The physicians’ activities in all areas included in the program increased, but there were considerable differences among the physicians and in the assimilation rate of the components, e.g., little attention was paid to fall prevention. Further action is therefore required to enhance physicians’ involvement in health promotion and preventive care and the proactive involvement of the elderly in maintaining their health.
The study findings have been presented to the management of Maccabi and are being used as the basis for identifying new directions for action so that family physicians incorporate and adapt some of the elements of the program more extensively. The program and the study findings have been presented at other health plans and at the Ministry of Health and have attracted praise and generated interest. The study is the result of an initiative and cooperation among research staff at the Myers-JDC-Brookdale Institute, the directors of Maccabi Healthcare Service, and ESHEL.