Investigation of Preventive Care in Sweden: Actions Planned and Performed in Response to Health Risks in Older Adults in Care
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Preventive care is vital in maintaining health and supporting independence among older persons. In Sweden, a national quality register (Senior Alert) was developed in elder care to support healthcare workers working to prevent malnutrition, falls, pressure ulcers, and poor oral health. However, we predicted that challenges in providing care at home result in preventive work being least used when and where it would be most effective: early in disease processes. The current study examines the preventive care actions planned and performed for older persons with identified risks, to compare quality and equity of care in different care settings. METHODS: Persons from the Swedish Screening Across the Lifespan Twin Study registered in the Senior Alert were included in the study (N = 2914). Descriptive and analytical statistical analyses regarding risk assessment and planned and performed preventive actions were conducted among those persons registered in hospitals, home health care, nursing homes, dementia care homes, or short-term nursing homes. RESULTS: Almost 80% of the sample had identified risk in at least one of the four risk areas, with falls and malnutrition being most common. Risks differed between care settings, and having any risk was most common among older persons in short-term nursing homes. The largest difference between planned and performed actions was for older persons with home health care, and especially true for the oldest persons (>80 years old). CONCLUSIONS: Preventive care is vital as it is often easier to prevent than treat, and pressure ulcers, malnutrition, poor oral health, and falls are common among older persons. However, preventive actions were less likely to be performed in the home health care, especially for the oldest adults. Reasons for this might be related to challenges of performing care in a person's home, lack of knowledge, and organizational challenges, but further investigation is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".