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Biomedical subjects

R J Perenboom

Publications and source records attributed to R J Perenboom.

10 recordsLinked to original sources
PubMed1997

Health expectancy calculations: a novel approach to studying population health in Bulgaria.

The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health. The indicators "disability-free life expectancy", "handicap-free life expectancy" and "healthy life expectancy" (based on self-perceived health) were calculated according to Sullivan's method. The results show, for example, that 8.0 of the 16.0 years that men aged 60 years may expect to live, on average, will be free of disability. For men aged 80 years the figures are 1.3 of 5.5 years. For women at 60 years and 80 years the results are 7.3 and 0.5 disability-free years of 19.2 and 7.3 expected life years, respectively. Similar results were found for handicap-free life expectancies and healthy life expectancies. At all ages, the proportion of life in a condition free of disability, free of handicap, or in perceived good health is substantially lower for women than for men. Women may expect to live longer, but a greater proportion of their life will be spent in poor health. The approach presented here for measuring the health status of the elderly may be helpful as an aid to planning medical and social care and for the development of public health policies.

Aged↗
PubMed1996

[Potential role for family physicians in pushing back age-related impairment: hearing and vision disorders, incontinence and arthrosis].

OBJECTIVE: To determine which age-related disorders lend themselves for screening followed by intervention in general practice. SETTING: Department of General Practice Medicine, University of Leiden. DESIGN: Descriptive. METHODS: This study concerned eight frequent age-related disorders: auditory and visual disorders, cognitive limitations, vertigo, incontinence, prostate symptoms, osteoarthritis and depressive symptoms. Four criteria (diagnostic possibilities, therapeutic possibilities, suitability of general practice for screening and intervention, the benefit of the programme to the elderly) were applied to selected literature (from Medicine and the electronic article files of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) and of Huisarts en Wetenschap (GP and Science) to find out whether screening followed by intervention appeared useful. RESULTS: With regard to three disorders (auditory and visual disorders and incontinence) it appeared possible to reduce the impairments caused by them, while in osteoarthritis, screening and intervention might lead to better mobility. CONCLUSION: With reference to recent literature, it appears theoretically possible to reduce the impairments caused by auditory and visual disorders, incontinence and osteoarthritis.

Aged↗
PubMed1996

Policy relevance of the health expectancy indicator; an inventory in European Union countries.

Due to epidemiological transitions in population health both an increase in life expectancy and in chronic morbidity and disability have been observed in many countries. Consequently the tension between 'living longer' on the one hand and the 'quality of life' on the other have become a central health policy problem. The introduction of the indicator 'health expectancy' (HE), a measurement that combines mortality data with morbidity and disability data, was a logical reaction to these changes and to the growing need of a present-day yardstick to estimate this problem. The HE indicator is still under development, a process being furthered by the international network of researchers, REVES. A European project, called Euro-REVES, aims to promote and harmonize future HE calculations in Europe. To begin this project and to gain more insight into the indicator's policy relevance, an inventory has been carried out among policy makers, National Statistical Institutes and researchers in countries of the European Union (EU). This paper presents the results of the inventory, attempts to place these within a provisional classification system of HE types, and discusses the consequences of the findings for further conceptual harmonization and development of the indicator. Already 11 of the 15 ER member states have HE results available. The actual use of such results for policy making is increasing. Notwithstanding a great diversity in sources and questions used for the calculations, there seems to be enough simularity to give the harmonization effort a good perspective.

Chronic Disease↗
PubMed1996

Occupational handicap-free life expectancy in Bulgaria 1976-1992 based on the data of the medical expert commissions.

This article presents health expectancy calculations from Bulgaria for 1976-1992. The calculations are based on mortality statistics and data from a national information system from the Expert Medical Commissions on Working Capacity about loss of working capacity. Following internationally accepted terminology, the most appropriate term for the health expectancies presented here is "occupational handicap-free life expectancy' (OHFLE). Life expectancies were calculated as partial life expectancies from ages 16 to 59. Health expectancy calculations followed Sullivan's cross-sectional method with age and sex specific prevalence data on occupational handicap. Around 1985 a three- to four-fold increase in these prevalences occurred. The distribution of occupational handicaps over sexes, age groups and severity levels, however, remained fairly constant. The results show a decrease both in partial life expectancy within the age range 16-59 and in OHFLE at the age of 16 for men. For women a more or less stable partial life expectancy and a decrease in OHFLE at the age of 16 was found around 1985. The introduction of more incentives for people who successfully registered probably caused the decrease around 1985. Major social changes may have acted as confounding factors for the fluctuations after 1985. On the other hand the findings may reflect real changes in population health due to an increasing incidence in some major disease categories. The nation-wide system for assessment and registration of health related working incapacity has proved a useful source for an attempt to calculate OHFLE. Given uncertainties about the population health underlying these changes in OHFLE, however, it is recommended that health interview and health examination surveys should be considered as alternative routes for achieving a more comprehensive picture of population health in Bulgaria.

Adolescent↗
PubMed1996

Dementia-free life expectancy (DemFLE) in The Netherlands.

To gain an insight into the burden of dementia in an aging society, life expectancy with dementia and its counterpart dementia-free life expectancy (DemFLE) in The Netherlands are presented. Sullivan's method was used to calculate DemFLE. For elderly living either independently or in homes for the elderly prevalence figures on dementia were obtained from the Rotterdam Elderly Study (RES; n = 7528); for elderly in nursing homes the SIG Nursing home Information System was used. Conforming to other authors only the prevalence data on moderate and severe dementia as diagnosed with DSM-III-R criteria are used. The prevalence of mild dementia was not taken into account. At 65 years DemFLE for men is 14.0 years, that is 96.4% of the total life expectancy (14.5 years at this age). At age 90, DemFLE for men is 2.5 years, equal to 77.5% of the total life expectancy (3.3 years). For women DemFLE at age 65 is 17.7 years, that is 93.2% of their life expectancy (19.0 years), and at the age of 90, DemFLE for women is 2.8 years, equal to 74.7% of their remaining life expectancy (3.8 years). The absolute number of years with dementia remains relatively constant with increasing age. About 20-25% of these years with dementia are spent in nursing homes, the other 75-80% living independently. At each age compared with men women have both a higher DemFLE and a higher expectancy of years with dementia. The percentage of life expectancy without dementia however, is always lower for women, because of their higher total life expectancy. This indicates that the burden of dementia in absolute and relative terms is higher for women. Most years with dementia are spent at home, indicating that the burden of dementia rests mainly on the shoulders of informal caregivers.

Aged↗
PubMed1996

Increasing the coverage of vaccination against influenza by general practitioners.

BACKGROUND: To increase the coverage of influenza vaccination in groups of patients at risk, an experiment was conducted in 1993, aimed at logistic support of general practitioners (GPs). METHODS: Support was given to 56 GPs with 133,000 patients to select and invite patients at risk. The coverage of vaccination as a result of this experiment has been compared with the results obtained from the Health Interview Survey, in The Netherlands as a total. RESULTS About 15,000 patients at risk were invited for vaccination, of whom 75.5 per cent were vaccinated. In The Netherlands as a total, the coverage of patients at risk was 43 per cent. CONCLUSION: Because the selection and invitation of patients at risk is still a problem for many GPs, owing to the lack of computerization, logistic support can ease these tasks and thus help increase the coverage of vaccination against influenza in groups of patients at risk.

Family Practice↗
PubMed1995

[Increase of degree of vaccination against influenza in at-risk patients by directed primary care invitation].

OBJECTIVE: To increase the coverage of influenza vaccination by a programmatic approach in a large population, aimed at the general practitioners (GPs). DESIGN: Intervention study (prospective). SETTING: The region of central Brabant (Tilburg and some surrounding communities), the Netherlands. METHOD: The intervention was carried out in a population of 133,000 people (registered at 42 offices of 56 GPs, and at 27 pharmacies). Medication data from pharmacists were used for the selection of patients at risk by the GPs. RESULTS: About 15,000 patients were selected by the GPs and invited for vaccination. The (final) coverage was 75.5% in 1993, a 56% increase over 1992. The increase in the group of comparable but non-participating GPs was 18%, in the Netherlands as a whole it was 8%. CONCLUSION: It is quite possible to achieve a considerable increase of the coverage of influenza vaccination.

Aged↗
PubMed1995

The European health potential: what can we learn from each other?

In this paper global differences in health between the 12 countries of the European Union are compared and related to variations in so-called determinants of health, especially socio-economic and life style factors and characteristics of the health care system in each country. This leads to two main conclusions. The first conclusion is that the health differences that exist within the European Union can only be partially explained by variations in determinants of health. Still, the comparison offers intriguing clues for improving health, containing cost and further research in the European Union. The second conclusion is that considerable data on health and determinants of health are collected in each country, but that international comparability is still limited. The ongoing activities in the standardization of European data collection need our full support.

Cross-Cultural Comparison↗
PubMed1988

Health status and medical consumption of rural and urban elderly.

Health status and medical consumption by the elderly seem to be dependent on the place of residence. Several studies have shown that rural elderly are less healthy, but make less use of health services than urban elderly. In this study it has been found that in The Netherlands differences in health and use of health services between both groups are very small, but also that rural elderly have a better health than urban elderly and that these rural elderly make less use of health services. Explanations for this phenomenon cannot be found in differences in income, social contacts, social participation or care delivery systems. Migration also cannot explain the differences. Possible explanations are sought in the urbanization of the rural area. The small differences might be due to the operationalization of the concept urbanization.

Activities of Daily Living↗