scholarly journals The distribution of health services for older people in Australia: where does transition care fit?

2009 ◽  
Vol 33 (4) ◽  
pp. 572 ◽  
Author(s):  
Lynne C Giles ◽  
Julie A Halbert ◽  
Maria Crotty ◽  
Ian D Cameron ◽  
Len C Gray
Keyword(s):  
Rural Communities ◽  
Older People ◽  
Rural Areas ◽  
Care Service ◽  
Care Program ◽  
Aged Care ◽  
Care Services ◽  
Transition Care ◽  
Care Assessment ◽  
Hospital Beds

Introduction: The purpose of this study was to describe the distribution of hospital and aged care services for older people, with a particular focus on transition care places, across Australia and to determine the relationships between the provision of these services. Methods: Aggregation of health and aged care service indicators by Aged Care Assessment Team (ACAT) region including: public and private acute and subacute (rehabilitation and geriatric evaluation and management) hospital beds, flexible and mainstream aged care places as at 30 June 2006. Results: There was marked variation in the distribution of acute and subacute hospital beds among the 79 ACAT regions. Aged care places were more evenly distributed. However, the distribution of transition care places was uneven. Rural areas had poorer provision of all beds. There was no evidence of coordination in the allocation of hospital and aged care services between the Commonwealth and state/territory governments. There was a weak relationship between the allocation of transition care places and the distribution of health and aged care services. Discussion: Overall, the distribution of services available to older persons is uneven across Australia. While the Transition Care Program is flexible and is providing rural communities with access to rehabilitation, it will not be adequate to address the increasing needs associated with the ageing of the Australian population. An integrated national plan for aged care and rehabilitation services should be considered.

scholarly journals Multi-Dimensional Accessibility Barriers in Care Services for the Rural Elderly with Disabilities: A Qualitative Study in China

2021 ◽  
Vol 18 (12) ◽  
pp. 6373
Author(s):  
Yuan Wang ◽  
Caiyun Qi
Keyword(s):  
Older People ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Service ◽  
Quality Care ◽  
People With Disabilities ◽  
Support Network ◽  
Social Care Service ◽  
Care Services ◽  
Accessibility Barriers

This research covers a multi-dimensional investigation into accessibility barriers in care services for older people with disabilities in rural China. In-depth interviews with 13 rural disabled older people in China were conducted using qualitative methods. Based on a welfare pluralism approach, the results showed that in comparison with urban areas, care services for disabled older populations in rural areas are more subject to social barriers. This can be seen in the limited state (lack of resources, rigorous eligibility qualifications, uneven distribution, and irregular implementation); the absent market (low levels of consumption, high cost pressures, self-exclusion, and traditional cultural constraints); absent NGOs and volunteers (difficulties in access for NGOs and volunteers outside the area and formation difficulties of local NGOs and volunteers); as well as low-quality care in households and communities (unprofessional care from the spouse, unsustainable care from children, and unavailable community-based care). A multi-subject support network should be established to remove accessibility barriers to care services for older people with disabilities in rural areas through active intervention and interaction. The results of the research provide insights that will aid in the formulation of future social care service plans and health policies for rural older people with disabilities.

IMPACT OF POST-ACUTE TRANSITION CARE FOR FRAIL OLDER PEOPLE: A PROSPECTIVE STUDY

2013 ◽  
pp. 1-7
Author(s):  
N.M. PEEL ◽  
R.E. HUBBARD ◽  
L.C. GRAY
Keyword(s):  
Older People ◽  
Care Program ◽  
Aged Care ◽  
Functional Improvement ◽  
Residential Aged Care ◽  
Frail Older People ◽  
Care Needs ◽  
Post Discharge ◽  
Transition Care

Objectives:To describe the characteristics and outcomes of frail older people in a post-acutetransitional care program and to compare the recovery trajectories of patients with high and low care needs todetermine who benefits from transition care. Design:Prospective observational cohort. Participants and Setting:351 patients admitted to community-based transition care in two Australian states during an 11 monthrecruitment period. Intervention:Transition care provides a package of services including personal care,physiotherapy and occupational therapy, nursing care and case management post discharge from hospital. It istargeted at frail older people who, in the absence of an alternative, would otherwise be eligible for admission toresidential aged care. Measurements: A comprehensive geriatric assessment using the interRAI Home Careinstrument was conducted at transition care admission and discharge. Primary outcomes included changes infunctional ability during transition care, living status at discharge and six months follow-up, and hospital re-admissions over the follow-up period. For comparison of outcomes, the cohort was divided into two groups basedon risk factors for admission to high or low-level residential aged care. Results:There were no significantdifferences between groups on outcomes, with over 85% of the cohort living in the community at follow-up.More than 80% of the cohort showed functional improvement or maintenance of independence during transitioncare, with no significant differences between the groups. Conclusions:Post-acute programs should not betargeted solely at fitter older people: those who are frail also have the potential to gain from community-basedrehabilitation.

scholarly journals Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

2012 ◽  
Vol 36 (4) ◽  
pp. 430 ◽  
Author(s):  
Natasha K. Brusco ◽  
Nicholas F. Taylor ◽  
Ilana Hornung ◽  
Shanandoah Schaffers ◽  
Anna Smith ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Care Program ◽  
Aged Care ◽  
The Other ◽  
Discharge Destination ◽  
Low Level ◽  
Transition Care ◽  
Care Assessment ◽  
High Level ◽  
Mobility Status

Objective. To investigate factors that predict discharge destination for patients making the transition from hospital to the community. Methods. Using a prospective cohort design, 696 patients from 11 Transition Care Programs were recruited. Baseline patient and program characteristics were considered for predicting discharge destination, functional status, and patient length of stay. Results. An increased physiotherapy staffing ratio in Transition Care Program was associated with an increased likelihood that a patient was discharged home, with an improved functional or mobility status, and after a shorter length of stay. The other factor that predicted discharge to home included having an Aged Care Assessment Service classification of low level care or home with a support package. An increased physiotherapy staffing level also reduced the likelihood of discharge to low level or high level care. The other factors that predicted discharge to low level care were having higher mobility status and older age; the other factor associated with increased likelihood of predicting discharge to high level care was having an Aged Care Assessment Service classification of high level care. Conclusions. Factors on admission that predicted discharge destination were program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status. What is known about the topic? In 2004/05 Australia introduced a program called the Transition Care Program (TCP), which targets older persons at the conclusion of an acute hospital episode who require more time and support in a non-acute setting to complete their restorative process and optimise their functional capacity. This program has a particular objective to prevent inappropriate admission to a residential aged care facility. To date, there are no published papers that report the factors that predict discharge destination for patients in the Transition Care Program. What does this paper add? This study provides evidence that program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status are predictive of an increased likelihood that a patient will be discharged home with an improved functional/mobility status, after a shorter length of stay. What are the implications for practitioners? Knowledge of factors that predict discharge destination may assist healthcare practitioners and health managers in managing TCP patients and planning services.

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 Identifying the Association Between Older Adults' Characteristics and Their Health-Related Outcomes in a Transition Care Setting: A Retrospective Audit

2021 ◽  
Vol 9 ◽  
Author(s):  
Jo-Aine Hang ◽  
Jacqueline Francis-Coad ◽  
Chiara Naseri ◽  
Angela Jacques ◽  
Nicholas Waldron ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Care Service ◽  
Aged Care ◽  
Functional Improvement ◽  
Residential Aged Care ◽  
Discharge Destination ◽  
Transition Care ◽  
Retrospective Audit ◽  
Health Related

Introduction: Continued evaluation of Transition Care Programs (TCP) is essential to improving older adults' outcomes and can guide which older adults may benefit from undertaking TCP. The aim of this study was to audit a transition care service to identify the association between the characteristics of older adults undertaking a facility-based TCP and (i) discharge destination and (ii) functional improvement.Materials and methods: An audit (n = 169) of older adults aged 60 years and above who completed a facility-based TCP in Australia was conducted. Outcomes audited were performance of activities of daily living (ADL) measured using the Modified Barthel Index (MBI) and discharge destination. Data were analyzed using logistic regression and linear mixed modeling.Results: Older adults [mean age 84.2 (±8.3) years] had a median TCP stay of 38 days. Fifty-four older adults (32.0%) were discharged home, 20 (11.8%) were readmitted to hospital and 93 (55%) were admitted to permanent residential aged care. Having no cognitive impairment [OR = 0.41 (95% CI 0.18-0.93)], being independent with ADL at admission [OR = 0.41 (95% CI 0.16-1.00)] and a pre-planned team goal of home discharge [OR = 24.98 (95% CI 5.47-114.15)] was significantly associated with discharge home. Cases discharged home showed greater improvement in functional ability [MBI 21.3 points (95% CI 17.0-25.6)] compared to cases discharged to other destinations [MBI 9.6 points (95% CI 6.5-12.7)].Conclusion: Auditing a facility-based TCP identified that older adults who were independent in ADL and had good cognitive levels were more likely to be discharged home. Older adults with cognitive impairment also made clinically significant functional improvements.

scholarly journals Online multidisciplinary integrated rural healthcare education programs during the COVID-19 pandemic for students from different universities: experiences and guidelines

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Frances Barraclough ◽  
Sabrina Pit
Keyword(s):  
Rural Communities ◽  
Rural Health ◽  
Health Workforce ◽  
Rural Areas ◽  
Critical Mass ◽  
Aged Care ◽  
Residential Aged Care ◽  
Teaching Program ◽  
Content Type ◽  
Rural Health Workforce

PurposeThe COVID-19 pandemic has led to “forced innovation” in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline of rural health practitioners to meet the needs of rural communities. This paper describes the implementation of an online multidisciplinary teaching program focusing on integrated care and the needs of rural communities.Design/methodology/approachA multidisciplinary teaching program was adapted to allow students from various disciplines and universities to learn together during the COVID-19 pandemic. Contemporary issues such as the National Aged Care Advocacy Program for Residential Aged Care COVID-19 Project were explored during the program.FindingsThis case study describes how the program was adopted, how learning needs were met, practical examples (e.g. the Hand Hygiene Advocacy within a Rural School Setting Project), the challenges faced and solutions developed to address these challenges. Guidelines are proposed for remote multidisciplinary learning among health professional students, including those in medical, nursing, pharmacy, dentistry, and allied health disciplines.Originality/valueThe originality of this program centers around students from multiple universities and disciplines and various year levels learning together in a rural area over an extended period of time. Collaboration among universities assists educators in rural areas to achieve critical mass to teach students. In addition it provides experiences and guidance for the work integrated learning sector, rural health workforce practitioners, rural clinical schools, universities, policy makers, and educators who wish to expand rural online multidisciplinary learning.

scholarly journals Geographic Access to Stroke Care Services in Rural Communities in Ontario, Canada

2020 ◽  
Vol 47 (3) ◽  
pp. 301-308 ◽  
Author(s):  
Moira K. Kapral ◽  
Ruth Hall ◽  
Peter Gozdyra ◽  
Amy Y.X. Yu ◽  
Albert Y. Jin ◽  
...  
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Stroke Prevention ◽  
Inpatient Rehabilitation ◽  
Stroke Care ◽  
Acute Stroke Care ◽  
Geographic Access ◽  
Prevention Services ◽  
Care Services ◽  
Driving Time

ABSTRACT:Background:Optimal stroke care requires access to resources such as neuroimaging, acute revascularization, rehabilitation, and stroke prevention services, which may not be available in rural areas. We aimed to determine geographic access to stroke care for residents of rural communities in the province of Ontario, Canada.Methods:We used the Ontario Road Network File database linked with the 2016 Ontario Acute Stroke Care Resource Inventory to estimate the proportion of people in rural communities, defined as those with a population size <10,000, who were within 30, 60, and 240 minutes of travel time by car from stroke care services, including brain imaging, thrombolysis treatment centers, stroke units, stroke prevention clinics, inpatient rehabilitation facilities, and endovascular treatment centers.Results:Of the 1,496,262 people residing in rural communities, the majority resided within 60 minutes of driving time to a center with computed tomography (85%), thrombolysis (81%), a stroke unit (68%), a stroke prevention clinic (74%), or inpatient rehabilitation (77.0%), but a much lower proportion (32%) were within 60 minutes of driving time to a center capable of providing endovascular thrombectomy (EVT).Conclusions:Most rural Ontario residents have appropriate geographic access to stroke services, with the exception of EVT. This information may be useful for jurisdictions seeking to optimize the regional organization of stroke care services.

scholarly journals Sustainable community services for older people

2020 ◽  
Author(s):  
Chris Taylor ◽  
Jed Donoghue
Keyword(s):  
Older People ◽  
State Government ◽  
Aged Care ◽  
Community Services ◽  
Government Support ◽  
Care Services ◽  
Strategic Plans ◽  
Authority Area ◽  
Key Issues

This paper explores the sustainability of non-government organisations (NGOs) providing services to older people in the local government authority area of North Sydney. It identifies several key issues that can be used to assess the level of programme sustainability in the community sector. We suggest that government support is essential for the ongoing financial sustainability of community aged care services and that community-based organisations need to address a number of issues that will impact on their long-term sustainability. A good working relationship with local and state government is crucial for organisations to access community grants, donations and subsidised premises. The recruitment, training and retention of volunteers were some of the most important issues identified. Further, these NGOs will need to develop strategic plans that factor in sustainability indicators to address rental, recycling, transport, renewable energy and water costs to ensure that they have the capacity to pay for these utilities in the future.

scholarly journals The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program

2016 ◽  
Vol 45 (2) ◽  
pp. 317-320 ◽  
Author(s):  
Tracy A. Comans ◽  
Nancye M. Peel ◽  
Ruth E. Hubbard ◽  
Andrew D. Mulligan ◽  
Leonard C. Gray ◽  
...  
Keyword(s):  
Older People ◽  
Healthcare Costs ◽  
Care Program ◽  
Transition Care

‘User pays’ and other approaches to the funding of long-term care for older people in Australia

2000 ◽  
Vol 20 (1) ◽  
pp. 5-32 ◽  
Author(s):  
MICHAEL FINE ◽  
JENNY CHALMERS
Keyword(s):  
Older People ◽  
Private Insurance ◽  
Aged Care ◽  
Future Generations ◽  
Term Care ◽  
Public And Private ◽  
Alternative Funding ◽  
Care Services ◽  
The Cost

It has been argued that without some system in which future generations of users are able to pay for their care the cost of services for an increasingly large group of older people will be borne by a declining base of economically active younger people. Is the answer a user pays approach to the financing of aged care, as promoted by recent changes to aged care financing? This paper reviews this concept and its recent history in Australia. On the basis of a brief review of alternative funding systems, it also considers the potential of public and private insurance schemes to increase funding by potential service users and underwrite the long-term viability of funding for aged care services.

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