Proposta de um índice de vulnerabilidade clínico-funcional para a Atenção Básica: um estudo comparativo com a avaliação multidimensional do idoso

Abstract

The expressive reduction of fertility and mortality rates, associated with an elevation in life expectancy, has led to important demographic changes in Brazil, with the resulting aging of the population, in a context of deep social transformation. This scenario presents public health services with important challenges due to an increase in the demand for specialized attention to elderly citizens brought about by a higher prevalence of chronic-degenerative diseases, functional disabilities, and the development of neoplasms related to the aging process. In a way, many primary care professionals tend to interpret that any individual above 60 years of age, legally an elderly citizen, should be referred to secondary care, independently of his or her clinical-functional condition. Unnecessary appointments, however, use time, resources, and manpower that could be better allocated if secondary care received, predominantly, vulnerable or frail patients. This study evaluated the pertinence of using a questionnaire, the Clinical-Functional Vulnerability Index, to be used by primary care to identify the clinical-functional condition of elderly individuals, as a screening mechanism to select the patients who must be referred to secondary care. The study showed that the questionnaire has a high degree of reliability and validity, proving to be a quick, simple, multidimensional instrument, probably adequate for its purposes.