Modeling the Association Between Home Care Service Use and Entry Into Residential Aged Care: A Cohort Study Using Routinely Collected Data

2018 ◽  
Vol 19 (2) ◽  
pp. 117-121.e3 ◽  
Author(s):  
Mikaela Jorgensen ◽  
Joyce Siette ◽  
Andrew Georgiou ◽  
Andrew Warland ◽  
Johanna Westbrook
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Service Use ◽  
Care Service ◽  
Aged Care ◽  
Home Care Service ◽  
Residential Aged Care ◽  
Routinely Collected Data

scholarly journals Housing and Care for Older Women in Australia

2021 ◽  
Vol 9 ◽  
Author(s):  
Julie E. Byles ◽  
Emily M. Princehorn ◽  
Peta M. Forder ◽  
Md Mijanur Rahman
Keyword(s):  
Service Use ◽  
Care Service ◽  
Later Life ◽  
Aged Care ◽  
Community Services ◽  
Residential Aged Care ◽  
Institutional Setting ◽  
Care Needs ◽  
Housing Type ◽  
Care Assessment

Background: Housing is essential for healthy ageing, being a source of shelter, purpose, and identity. As people age, and with diminishing physical and mental capacity, they become increasingly dependent on external supports from others and from their environment. In this paper we look at changes in housing across later life, with a focus on the relationship between housing and women's care needs.Methods: Data from 12,432 women in the 1921–26 cohort of the Australian Longitudinal Study on Women's Health were used to examine the interaction between housing and aged care service use across later life.Results: We found that there were no differences in access to home and community care according to housing type, but women living in an apartment and those in a retirement village/hostel were more likely to have an aged care assessment and had a faster rate of admission to institutional residential aged care than women living in a house. The odds of having an aged care assessment were also higher if women were older at baseline, required help with daily activities, reported a fall, were admitted to hospital in the last 12 months, had been diagnosed or treated for a stroke in the last 3 years, or had multiple comorbidities. On average, women received few services in the 24 months prior to admission to institutional residential aged care, indicating a potential need to improve the reach of these services.Discussion: We find that coincident with changes in functional capacities and abilities, women make changes to their housing, sometimes moving from a house to an apartment, or to a village. For some, increasing needs in later life are associated with the need to move from the community into institutional residential aged care. However, before moving into care, many women will use community services and these may in turn delay the need to leave their homes and move to an institutional setting. We identify a need to increase the use of community services to delay the admission to institutional residential aged care.

scholarly journals Relationship between home care service use and changes in the care needs level of Japanese elderly

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Gohei Kato ◽  
Nanako Tamiya ◽  
Masayo Kashiwagi ◽  
Mikiya Sato ◽  
Hideto Takahashi
Keyword(s):  
Home Care ◽  
Service Use ◽  
Care Service ◽  
Home Care Service ◽  
Care Needs ◽  
Japanese Elderly

Publicly funded home care service use in the first 2 years after spinal cord injury in Ontario, Canada

2020 ◽  
Vol 39 (2) ◽  
pp. 95-106
Author(s):  
Brian Chun-Fai Chan ◽  
Shawna Cronin ◽  
Susan B. Jaglal ◽  
Beverley Catharine Craven
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Home Care ◽  
Service Use ◽  
Care Service ◽  
Home Care Service ◽  
Publicly Funded ◽  
Cord Injury

scholarly journals Comparison of Time-Varying and Landmark Analysis Methods in Estimating the Association Between Medication Adherence and Outcomes: A Heart Failure Cohort

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Benjumin Hsu ◽  
Louisa Jorm
Keyword(s):  
Heart Failure ◽  
Service Use ◽  
Cox Regression ◽  
Care Service ◽  
Aged Care ◽  
Residential Aged Care ◽  
Ageing In Place ◽  
Care Services ◽  
Relative Risks ◽  
Hospital Stays

IntroductionCardiovascular disease (CVD) is a leading contributor to disease burden worldwide. Older people hospitalized with CVD might experience significant decline in physical function and loss of independence. Objectives and ApproachThe aim of this study was to investigate the use of community aged care (CAC) and permanent residential aged care (PRAC) services 3 months, 6 months and 12 months after hospital admission for myocardial infarction (MI), stroke and congestive heart failure (CHF). Survey data from the 45 and Up Study (2006-09) for 266,942 people aged 45+ was linked with records for hospital stays (APDC), aged care service use (NACDC), and deaths (RBDM) for 2006-14 through CHeReL and AIHW. Relative risks of using aged care (CAC or PRAC) after MI, stroke or CHF hospitalization were estimated using Cox regression. We described and visualized sequences of health service states (none, re-hospitalization, CAC, PRAC, death) after the index hospitalization. ResultsCompared with people without MI, people hospitalized with a principal diagnosis of MI (multivariable-adjusted HR:1.11, 95%CI:1.04-1.18), stroke (HR:1.52, 95%CI:1.43-1.61) and CHF (HR:1.12, 95%CI:1.06-1.19) were more likely to use CAC within 3 months of the hospital discharge. Likewise, people with MI (HR:1.16, 95%CI:1.03-1.29), stroke (HR:2.81, 95%CI:2.58-3.05) and CHF (HR:1.36, 95CI:1.24-1.49) were more likely to enter PRAC within 3 months of discharge. Similar findings were observed for 6 months and 12 months. MI, stroke and CHF patients were more likely to die but less likely to be re-hospitalized after the first 3 months. The number use of CAC and PRAC remains unchanged over 12 months. While this study provides a broadly representative sample of the older population, participants may be healthier than the general population. Conclusion / ImplicationsCVD increases use of community and residential care services. Coordination of cardiac and stroke rehabilitation is warranted to maximize ageing in place.

scholarly journals Characteristics associated with residential aged care, respite and transitional aged care placement for older people following an injury-related hospitalisation in Australia

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Rebecca Mitchell ◽  
Lara Harvey ◽  
Brian Draper ◽  
Henry Brodaty ◽  
Jacqui Close
Keyword(s):  
Service Use ◽  
Transitional Care ◽  
Care Service ◽  
Aged Care ◽  
Personal Hygiene ◽  
Residential Aged Care ◽  
Older Individuals ◽  
Leg Injuries ◽  
Arm Injuries ◽  
Related Hospitalisation

Objective: This study examines characteristics associated with permanent residential aged care (RAC), respite RAC and transitional care (TC) placement for older individuals following an injury-related hospitalisation. Method: A retrospective analysis of individuals aged ≥65 years who had an injury-related hospitalisation and who had a linked record in RAC, TC or activities of daily living (ADL) data between 1 July 2008 and 30 June 2013 in New South Wales, Australia. Comorbidities were identified using diagnosis classifications and a 1-year lookback period. All hospital episodes of care related to the injury were linked to form a period of care. Both new and existing admissions to RAC were examined. Multinominal logistic regression was used to examine the factors associated with new admissions to permanent RAC, respite RAC and TC compared to return to the community. Results: Of 191,301 injury-related hospitalisations, 41,085 (21.5%) individuals either returned or were new admissions to permanent (87.2%) or respite (12.8%) RAC and 3,218 (1.7%) individuals were admitted to TC. There were 3,864, 4,314 and 2,630 new admissions to permanent RAC, respite RAC and TC, respectively. Of the injury hospitalisations, 70,796 (37.0%) individuals had an ADL assessment. Compared to individuals who returned to the community, individuals newly admitted to permanent RAC were four times as likely to have dementia (OR: 4.36; 95%CI 4.15-4.57), those admitted to respite RAC were twice as likely to have dementia (OR: 2.37; 95%CI 2.21-2.54) and people admitted to TC people were less likely to have dementia (OR: 0.60; 95%CI 0.53-0.68). Individuals with shoulder and upper arm injuries were twice as likely (OR: 2.31; 95%CI 1.98-2.68) and individuals with knee and lower leg injuries were one and a half times as likely (OR: 1.87; 95%CI 1.60-2.18) to be admitted to TC. Overall, individuals who were admitted to permanent or respite RAC had a higher likelihood of experiencing limitations associated with their physical, cognitive or social abilities, with individuals admitted to TC having a higher likelihood of having limitations maintaining personal hygiene and mobility compared to individuals returning to the community. Conclusion: An understanding of the profile of which older individuals are using RAC (permanent or respite) or TC services can usefully inform current and future aged care service use.

scholarly journals Cohort profile: Dementia in the Registry of Senior Australians

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e039907
Author(s):  
Monica Cations ◽  
Catherine E Lang ◽  
Stephanie A Ward ◽  
Maria Crotty ◽  
Craig Whitehead ◽  
...  
Keyword(s):  
Service Use ◽  
Care Service ◽  
Aged Care ◽  
Residential Aged Care ◽  
Assessment Data ◽  
Cross Sectional ◽  
People With Dementia ◽  
Psychotropic Medicine ◽  
Care Assessment ◽  
The Impact

PurposeClinical quality registries (CQRs) are being established in many countries to monitor, benchmark, and report on the quality of dementia care over time. Case ascertainment can be challenging given that diagnosis occurs in a variety of settings. The Registry of Senior Australians (ROSA) includes a large cohort of people with dementia from all Australian states and territories identified using routinely collected aged care assessment data. In ROSA, assessment data are linked to information about aged and health service use, medicine dispensing, hospitalisations and the National Death Index. The ROSA dementia cohort was established to capture people for the Australian dementia CQR currently in development who may not be identified elsewhere.ParticipantsThere were 373 695 people with dementia identified in aged care assessments from 2008 to 2016. Cross-sectional analysis from the time of cohort entry (e.g. when first identified with dementia on an aged care assessment) indicates that individuals were 84.1 years old on average, and 63.1% were female. More than 44% were first identified at entry to permanent residential aged care. The cohort recorded more severe cognitive impairment at entry than other international dementia registries.Findings to dateThe cohort has so far been used to demonstrate a declining prevalence of dementia in individuals entering the aged care sector, examine trends in psychotropic medicine prescribing, and to examine the impact of dementia on aged care service use and outcomes.Future plansThe ROSA dementia cohort will be updated periodically and is a powerful resource both on its own and as a contributor to the Australian dementia CQR. Integration of the ROSA dementia cohort with the dementia CQR will ensure that people with dementia using aged care services can benefit from the ongoing monitoring and benchmarking of care that a registry can provide.

The impact of dementia on aged care service transitions in the last five years of life

2020 ◽  
Author(s):  
Heidi J Welberry ◽  
Louisa R Jorm ◽  
Sebastiano Barbieri ◽  
Benjumin Hsu ◽  
Henry Brodaty
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Residential Care ◽  
Service Use ◽  
Care Service ◽  
Care Home ◽  
Aged Care ◽  
Dementia Diagnosis ◽  
People With Dementia ◽  
The Impact

Abstract Objective To investigate the impact of dementia on aged care service use at end-of-life. Methods Our retrospective data linkage study in New South Wales, Australia, used survey data from participants in the 45 and Up Study who died between July 2011–June 2014 linked to routinely collected administrative data for 2006–2014. We investigated movement between aged care “states” (No Services, Home Care including Home Support and Low-and High-Level Home Care and Residential Care) in the last five years of life. The dementia cohort comprised decedents with a dementia diagnosis recorded in hospital records, death certificates or who had claims for dementia-specific medicines prior to death (n = 2,230). The comparison cohort were decedents with no dementia diagnosis, matched 1:1 on age-at-death, sex, income and location. Results Compared to those without dementia, people with dementia were more likely to: use home care (67 versus 60%, P < 0.001), enter residential care (72 versus 30%, P < 0.001) and stay longer in residential care (median 17.9 versus 12.7 months, P < 0.001). Five years before death, more people with dementia were within residential care (6 versus 4%; RR = 1.61, 95%CI = 1.23–2.10) and these rates diverged at the end-of-life (69 versus 28%, RR = 2.48, 95%CI = 2.30–2.66). Use of home-based care was higher among people with dementia five years from death (20 versus 17%; RR = 1.15, 95%CI = 1.02–1.30) but lower at end-of-life (13 versus 24%, RR = 0.55, 95%CI = 0.49–0.63). Conclusion Dementia-specific aged care trajectories were dominated by residential care. Home care use declined towards end-of-life for people with dementia and may not be meeting their needs.

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