Cumulative incidence of admission to permanent residential aged care for Australian women – A competing risk analysis

Forder, Peta; Byles, Julie; Vo, Kha; Curryer, Cassie; Loxton, Deborah

doi:10.1111/1753-6405.12713

Cited by 8 publications

(11 citation statements)

References 25 publications

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“…These findings are consistent with several previous studies that report that older age, higher limitations in ADL, and falls are significantly associated with increased risk of RAC admission [12,31]. An earlier study on this cohort that focused on housing also reported a similar association of housing type with time to first RAC admission [11]. Although, those who are widowed or have multiple conditions are found to have an increased risk of transitioning to RAC in other studies, in our study these participants might be having enough HACC services or alternative services (e.g., HCP which was not covered in our study) to manage their conditions or other care needs in community settings.…”

Section: Discussionsupporting

confidence: 92%

“…Although this study provides significant insights into service outcomes of HCP, the participants were from only one HCP provider in New South Wales and Canberra, and were studied for a relatively small observation period. Furthermore, previous separate studies on HACC and RAC have reported that living in remote/rural areas is associated with increased odds of HACC use [7] but decreased risk of entering RAC [11]. Research is yet to explore whether high usage of HACC services reduce the risk of entering RAC.…”

Section: Introductionmentioning

confidence: 98%

“…Earlier studies have identified a number of risk factors to enter RAC, including older age, widowhood, living alone, low independence in activities in daily living (ADL), living in a flat or retirement village, falls, and cognitive impairment [11][12][13]. Besides the individuals' factors, greater volume of home-and community-based care use are associated with a reduced risk of subsequent nursing home admission in the USA [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

Rahman

Byles

2020

Maturitas

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

Rahman

Byles

2020

Maturitas

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“…English speaking, females, 80–89 years old constituted a large segment of our cohort and has been consistent over the years evaluated. Borotkanics et al [21], and Forder et al have reported that females aged between 70 and 90 years are more likely to enter PRAC [22]. Increased longevity is due to better health and primary health care, and so it is not surprising that aged care services are being used more often by people who have lived to a very advanced age which was identified in the study.…”

Section: Discussionmentioning

confidence: 81%

Trends in the utilisation of aged care services in Australia, 2008–2016

et al. 2019

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Background Aged care support services in Australia are delivered through home care packages, permanent residential care, respite care and transition care. This study aimed to determine age and gender specific incidence rates of aged care service utilisation in Australia between 2008-09 and 2015–16. Methods This is a population-based epidmiological study of people accessing aged care services in Australia. The trends and characteristics of people (over the age of 65 years old) accessing aged care services in Australia were evaluated, using data (2008–09 and 2015–16) from the Australian Institute of Health and Welfare and Australian Bureau of Statistics. The yearly utilisation incidence rates (per 1000 people) per service type were calculated and changes in incidence rate ratios (IRR) of service utilisation for the study period were estimated using Poisson regression models. Results The proportion of older Australians aged ≥65 years who used aged care services remained similar between 2008-09 (5.4%, N = 208,247) and 2015–16 (5.6%, N = 248,669). However, the incidence use of specific services changed during the study period. Specifically, admissions into permanent residential care decreased (from 23.8/1000 people in 2008–09 to 19.6/1000 in 2015–16, at a IRR of 0.84/year, p < 0.001) but increased for transition care (from 4.3/1000 in 2008–09 to 6.6/1000 in 2015–16, at a IRR of 1.57/year, p < 0.001) and home care packages (from 8.04/1000 in 2008–09 to 12.0/1000 per 1000 in 2015–16, at a IRR of 1.52/year, p < 0.001). Between 2008-09 and 2015–16, the greatest changes in IRR were observed in males aged 80–89 years accessing transition care (IRR = 1.68/year, p < 0.001). A higher proportion of people aged between 80-89 years (≥45%), females (≥60%), Australia born (≥ 60%) and English speakers (≥80%) used all the service types. Conclusions Patterns of service utilisation for aged care services changed over the study period with a decrease in incidence of individuals accessing permanent residential care but increased for other service types. This finding reflects changes in attitudes regarding ageing in place and policies. These findings are helpful to inform key stakeholders on service planning to further improve quality of the aged-care services in Australia.

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“…Participants with higher baseline age had an increased risk of transitioning from the non-user state to either HACC, RAC, death or transitioning from HACC to RAC. Those who lived in remote/inner/regional areas were associated with an increased hazard of transitioning from the non-user state to HACC [43] but a decreased hazard of transitioning from the non-user state to RAC [44]. These findings may reflect the availability of HACC in those areas, compared with limited accessibility to RAC.…”

Section: Discussionmentioning

confidence: 99%

Transitioning of older Australian women into and through the long-term care system: a cohort study using linked data

2019

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BackgroundOver two-thirds of older Australians use different types/levels of aged care at some point in later life. Our aims were to estimate transitional probabilities and to identify risk factors influencing the movement between different levels of long-term care.MethodsThe sample consisted of 9007 women from the 1921-26 birth cohort of the Australian Longitudinal Study on Women’s Health. Transitional probabilities between different levels of long-term care were estimated using a continuous-time Markov model.ResultsAn 11-fold transition rates ratio was observed for the movement from non-user to home and community care (HACC) versus non-user to residential aged care (RAC). The predicted probabilities of remaining in the non-user state, HACC, and RAC after 10 years from the baseline were .28, .24, and .11, respectively. While the corresponding probabilities of dying from these states were .36, .65, and .90. The risk of transitioning from the non-user state to either HACC or RAC was greater for participants who were older at baseline, widowed, living outside of major cities, having difficulties in managing income, or having chronic condition, poor/fair self-rated health, or lower SF-36 scores (p < .05).ConclusionWomen spend a substantial period of their later life using long-term care. Typically, this will be in the community setting with a low level of care. The transition to either HACC or RAC was associated with several demographic and health-related factors. Our findings are important for the planning and improvement of long-term care among future generations of older people.Trial registrationNot applicable.

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Cumulative incidence of admission to permanent residential aged care for Australian women – A competing risk analysis

Cited by 8 publications

References 25 publications

Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

Trends in the utilisation of aged care services in Australia, 2008–2016

Transitioning of older Australian women into and through the long-term care system: a cohort study using linked data

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