Restorative home-care services, or re-ablement home-care services as they are now known in the UK, aim to assist older individuals who are experiencing difficulties in everyday living to optimise their functioning and reduce their need for ongoing home care. Until recently, the effectiveness of restorative home-care services had only been investigated in terms of singular outcomes such as length of home-care episode, admission to hospital and quality of life. This paper reports on a more complex and perhaps more significant measure – the use and cost of the home-care and healthcare services received over the 2-year period following service commencement. Seven hundred and fifty older individuals referred for government-funded home care were randomly assigned to a restorative or standard service between June 2005 and August 2007. Health and aged care service data were sourced and linked via the Western Australian Data Linkage System. Restorative clients used fewer home-care hours (mean [SD], 117.3 [129.4] vs. 191.2 [230.4]), had lower total home-care costs (AU$5570 vs. AU$8541) and were less likely to be approved for a higher level of aged care (N [%], 171 [55.2] vs. 249 [63.0]) during follow-up. They were also less likely to have presented at an emergency department (OR = 0.69, 95% CI = 0.50–0.94) or have had an unplanned hospital admission [OR (95% CI), 0.69 (0.50–0.95)]. Additionally, the aggregated health and home-care costs of the restorative clients were lower by a factor of 0.83 (95% CI 0.72–0.96) over the 2-year follow-up (AU$19,090 vs. AU$23,428). These results indicate that at a time when Australia is facing the challenges of population ageing and an expected increase in demand for health and aged care services, the provision of a restorative service when an older person is referred for home care is potentially a more cost-effective option than providing conventional home care.
Background The Health and Wellbeing Surveillance System (HWSS) monitors the health status of the WA population. Its reliance on a landline sample frame and Computer Assisted Telephone Interview (CATI) must shift to mobile phone sample frames and novel online completion options, improving the representativeness of the HWSS data to the WA population. Methods Concurrent surveys in 2020 were run using three sample frames, the 2013 Electronic White Pages (EWP), the WA Electoral Roll (WAER) and a Sensis consumer database. The survey modes explored included CATI, online, and dual mode. Responses were weighted to the WA population. Response rates were compared between frames and modes. Differences in demographics, health risk factors, conditions and behaviours were investigated by comparing prevalence estimates and logistic regression modelling. Results Response rates were 20% for EWP CATI, 41% for Sensis CATI, 16% for Sensis online, and 10% for WAER online. Compared to EWP, the WAER and Sensis frame respondents were younger, had higher incomes and better education. Online respondents had higher prevalence of high psychological distress and lower prevalence of smoking compared with CATI. Conclusions The WAER and Sensis consumer database are valid sample frame options for the future of the HWSS. CATI gave the highest response rates, yet respondent differences by frame and mode were evident. WA Health is further exploring these options of modern sample frames and survey modes in 2021. Key messages Population health surveillance systems must modernise their sample frames and data collection modes to continue to provide reliable health prevalence estimates.
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