STRATIFICATION OF OLDER ADULTS IN THE VILA ANÁLIA II FAMILY HEALTH STRATEGY (MONTES CLAROS, MG): INTERVENTION PLAN USING THE IVCF-20

Abstract

The accelerated aging of the population in Brazil, with more than 32 million elderly people, represents a growing challenge for Primary Health Care (PHC), especially in combating chronic non-communicable diseases. At the ESF Vila Anália II, in Montes Claros-MG, which serves around 400 elderly people, the high concentration of elderly people with chronic diseases without adequate monitoring was identified as a priority problem, resulting in decompensation and a high demand for care. The critical issue defined was the lack of screening and risk stratification of the elderly population. Given this, this Intervention Plan proposes the stratification of 100% of registered elderly people through the application of the Clinical-Functional Vulnerability Index (IVCF-20), a validated and easy-to-use tool in PHC, with the aim of reorienting care and improving assistance. Strategic actions include team training, data collection and recording of information, screening and classification of elderly people into robust, pre-frail or frail, and implementation of targeted care plans, such as periodic monitoring and priority referral of frail elderly people for the Comprehensive Geriatric Assessment (AGA). The expected results are the early identification of frailty and risks of functional decline, the improvement of care and the reduction of adverse outcomes, such as avoidable hospitalizations, falls and loss of autonomy, promoting greater resolution and efficiency of the service.