Factors associated with accessing aged care services in Australia after approval for services: Findings from the historical cohort of the Registry of Senior Australians

Inacio, Maria C.S.; Amare, Azmeraw T.; Whitehead, Craig; Bray, Sarah C; Corlis, Megan; Visvanathan, Renuka; Wesselingh, Steve

doi:10.1111/ajag.12760

Cited by 11 publications

(12 citation statements)

References 13 publications

(37 reference statements)

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“…Not all individuals assessed for aged care services included in this study were approved for PRAC, and some approved for PRAC may not use this service. There are slight differences in the uptake of PRAC by State, with South Australia being most similar to Victoria and Western Australia [ 37 ]. Metropolitan location is also associated with increased use of PRAC [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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A vulnerable residential environment is associated with higher risk of mortality and early transition to permanent residential aged care for community dwelling older South Australians

et al. 2022

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Objectives This study examined the impact of the residential environment, measured by the Healthy Ageing/Vulnerable ENvironment (HAVEN) Index, on risk of mortality or entry into Permanent Residential Aged Care (PRAC). Design A retrospective cohort study using data from the Registry of Senior Australians (ROSA) was conducted. HAVEN Index values were matched to the ROSA by residential postcode. Study setting and Participants Older individuals living in metropolitan Adelaide and receiving their first eligibility assessment for aged care services between 2014 and 2016 (N = 16,944). Main Outcome Measure Time to death and entry into PRAC were the main outcomes. Results A higher HAVEN Index value, which represents a favourable residential environment, was associated with a lower risk of mortality and delayed entry to PRAC. For every 0.1 unit increase in HAVEN Index value, the risk of mortality is 3% lower (adjusted hazard ratio [HR], 95% confidence interval [CI] = 0.97, 0.96–0.99) and the risk of entry to PRAC is 5% lower (adjusted subdistribution HR, 95%CI = 0.95, 0.94–0.97) in the first 2 years following aged care assessment. After 2 years, the HAVEN Index was not associated with the risk of transition to PRAC. Conclusion Place-based health inequalities were identified in Australians seeking aged care services, demonstrating that a better understanding of local neighbourhoods may provide insight into addressing ageing inequalities. Spatial indexes, such as the HAVEN Index, are useful tools to identify areas where populations are more vulnerable to adverse health outcomes, informing responses to prioritise local improvements and health interventions to enable healthy ageing.

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Section: Discussionmentioning

confidence: 99%

“…There are slight differences in the uptake of PRAC by State, with South Australia being most similar to Victoria and Western Australia [ 37 ]. Metropolitan location is also associated with increased use of PRAC [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

A vulnerable residential environment is associated with higher risk of mortality and early transition to permanent residential aged care for community dwelling older South Australians

et al. 2022

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“…Approximately 840,000 older Australians access their aged care services via CHSP [ 11 ], and 145,000 via Home Care Packages [ 38 ]. However, whilst the intention of the CHSP program is that it provides services to older people with lower levels of care needs, in practice there is currently a large waiting list for the greater level of care provided by the HCP program [ 39 ], so there is a lot of overlap between the clients for these two programs. Face to face interviewer-facilitated data collection in residential care facilities was not possible due to COVID-19 restrictions in various states.…”

Section: Methodsmentioning

confidence: 99%

The integration of mixed methods data to develop the quality of life – aged care consumers (QOL-ACC) instrument

et al. 2021

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Background This paper describes the collection and integration of mixed methods data to facilitate the final selection of items for the Quality of Life – Aged Care Consumers (QOL-ACC) instrument. The aim of the wider project is to develop a preference-based quality of life instrument that can be used for quality assessment and economic evaluation. Older people have been involved at every stage of the development of the QOL-ACC to ensure that the final instrument captures their perspectives and preferences. Methods Mixed methods data was collected on draft items for the QOL-ACC instrument across six key quality of life dimensions (mobility, pain management, emotional well-being, independence, social connections, and activities). Qualitative face validity data was collected from older people (aged 66 to 100 years) living in the community and in residential aged care via semi-structured interviews (n = 59). Quantitative data was collected from older people (aged 65 to 91 years) receiving aged care services in the community via an online survey (n = 313). A traffic light pictorial approach was adopted as a practical and systematic way to categorise and present data in a meaningful way that was easy for non-academic workshop members to understand and to be able to discuss the relative merits of each draft item. Results The traffic light approach supported the involvement of consumer and aged care provider representatives in the selection of the final items. Six items were selected for the QOL-ACC instrument with one item representing each of the six dimensions. Conclusions This methodological approach has ensured that the final instrument is psychometrically robust as well as meaningful, relevant and acceptable to aged care consumers and providers.

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“…They are also likely to experience multiple transitions between community, acute and/or residential aged care settings. Those receiving home care packages in the community have high co‐morbidity, low levels of physical functioning, and high rates of depression and dementia 7 and are less likely to live with family or have a carer 8 . Those with more complex needs, including frailty and cognitive impairment, are also particularly susceptible to fluctuations in capacity.…”

Section: Introductionmentioning

confidence: 99%

Participation in future planning by community‐dwelling older Australians receiving aged care services: Findings from a cross‐sectional survey

et al. 2021

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Objectives To determine in a sample of older community‐dwelling adults: (1) the proportion who have engaged in medical and financial planning; (2) the factors associated with advance care directive (ACD) completion and substitute decision maker (SDM) appointment; and (3) for those without an ACD, what might prompt completion. Methods A cross‐sectional survey was undertaken with individuals receiving community aged care services in metropolitan and regional communities. Data collection was conducted by case managers during a home visit. Results Overall, 158 individuals (M = 78 years, SD = 8.7) participated (53.5% consent rate). Financial planning participation (will = 85%; enduring power of attorney = 66%) was higher than medical planning participation (SDM: 54%; ACD: 30%). No health status factors were significantly associated with ACD completion or SDM appointment. Diagnosis of a life‐limiting illness was most likely to prompt ACD completion (77.6%). Conclusions One third of older people residing in the community have completed an ACD. Strategies to improve uptake in this vulnerable population require further exploration.

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Factors associated with accessing aged care services in Australia after approval for services: Findings from the historical cohort of the Registry of Senior Australians

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 11 publications

References 13 publications

A vulnerable residential environment is associated with higher risk of mortality and early transition to permanent residential aged care for community dwelling older South Australians

A vulnerable residential environment is associated with higher risk of mortality and early transition to permanent residential aged care for community dwelling older South Australians

The integration of mixed methods data to develop the quality of life – aged care consumers (QOL-ACC) instrument

Participation in future planning by community‐dwelling older Australians receiving aged care services: Findings from a cross‐sectional survey

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