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Aged and Health Care Service Utilization by Older Australians Receiving Home Care Packages. J Am Med Dir Assoc 2023; 24:395-399.e2. [PMID: 36581309 DOI: 10.1016/j.jamda.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/17/2022] [Accepted: 11/26/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To examine the (1) cohort of individuals living at home with Home Care Packages (HCPs) in 2016, (2) their access to other aged care services after HCP commencement, and (3) their hospital and ambulance service utilization. DESIGN A cross-sectional study was conducted using integrated aged care and health care data contained within the National Historical Cohort of the Registry of Senior Australians. SETTING AND PARTICIPANTS This study included people who accessed HCP between January 1, 2016 and December 31, 2016. METHODS The access to permanent residential aged care, transition care, respite care, hospital and ambulance services among Australian HCP recipients ≥65 years old in 2016 was evaluated. Descriptive statistics were employed. RESULTS In 2016, 84,681 individuals received HCPs, of which 68.4% (n = 57,942) accessed HCP levels 1‒2, 26.0% (n = 22,057) accessed HCP levels 3‒4, and 5.5% (n = 4682) accessed both care levels within the year. Of the individuals receiving HCP, 34.0% (n = 27,787) started services that year and 16.7% (n = 14,117) moved to permanent residential aged care, 18.4% (n = 15,592) used respite care and 5.8% (n = 4937) used transition care that year. Emergency department (ED) presentations [43.6%, 95% confidence interval (CI) 43.3‒44.0] were the most common hospital encounters, followed by inpatient hospitalizations for any reason (43.3%, 95% CI 42.9‒43.7), and unplanned hospitalizations (38%, 95% CI 37.6‒38.3). Forty-four percent (44.5%, 95% CI 43.9‒45.0) of individuals utilized ambulance services. ED presentations, hospitalization for any reason, and unplanned hospitalizations were more common in individuals receiving HCP levels 3‒4 compared with those accessing HCP levels 1‒2. CONCLUSIONS AND IMPLICATIONS HCP recipients in Australia have frequent hospitalizations, including ED presentations. In addition, almost 1 in 5 access respite care and 16.7% transition to permanent residential care each year. As the population accessing HCP is increasing, adequate support for these individuals to live well at home and avoid health events that lead to hospitalizations are necessary.
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Inacio MC, Caughey GE, Wesselingh S. Registry of Senior Australians (ROSA): integrating cross-sectoral information to evaluate quality and safety of care provided to older people. BMJ Open 2022; 12:e066390. [PMID: 36396322 PMCID: PMC9676420 DOI: 10.1136/bmjopen-2022-066390] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The Registry of Senior Australians (ROSA) was established to evaluate aged care experiences in Australia. In this manuscript, we describe the ROSA framework, the two ROSA cohorts, highlights from research findings, and future plans. PARTICIPANTS The South Australian ROSA Prospective Cohort (August 2018-June 2020) enrolled 26 605 participants, of which 59.2% (N=15 745) are women, with a median age of 83 (interquartile range (IQR) 77-88). The National ROSA Historical Cohort (January 2002-June 2020) includes 1 694 206 participants with an aged care eligibility assessment, of which 59.1% (N=1 001 705) are women and the median age is 78 (IQR 72-83). FINDINGS TO DATE Most research using the ROSA has focused on dementia, service accessibility, quality and safety of care, falls and injuries and quality use of medicines. The ROSA has also examined the experience of individuals with highly prevalent and understudied conditions in aged care settings (eg, eye and mental health) and aspects of services (eg, built environment) and innovation (eg, mobile radiological services) that can affect older people's health. Important learnings from the ROSA's development include the significant resources and multidisciplinary expertise required for establishing this platform. Between 2018 and 2022, 43 academic publications, eight reports of the Australian Government Royal Commission into Aged Care Quality and Safety, and several reports to state health authorities and professional societies have used the ROSA. FUTURE PLANS Our plans include to: (1) continue delivering high-quality evidence to support the improvement of ageing and aged care services; (2) influence and improve the quality of research in and for the aged care sector; (3) expand scope to facilitate examining aims in more depth; (4) include future aged care sector data collections within the ROSA; (5) inform best practices and innovate how consumer engagement occurs in research; (6) monitor and evaluate the impact of the 2021 Australian Aged Care Reforms.
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Affiliation(s)
- Maria C Inacio
- Registry of Older South Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Gillian Elizabeth Caughey
- Registry of Older South Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Steve Wesselingh
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Itokazu M, Ishizaka M, Uchikawa Y, Takahashi Y, Niida T, Hirose T, Ito A, Yakabi A, Endo Y, Sawaya Y, Igawa T, Kobayashi K, Hara T, Watanabe M, Kubo A, Urano T. Relationship between Eye Frailty and Physical, Social, and Psychological/Cognitive Weaknesses among Community-Dwelling Older Adults in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13011. [PMID: 36293591 PMCID: PMC9602133 DOI: 10.3390/ijerph192013011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model's goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145-5.188], cognitive function (OR 2.047, 95%CI 1.051-3.984), and depressed mood (OR 1.820, 95%CI 1.163-2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties.
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Affiliation(s)
- Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshikazu Uchikawa
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Takahashi
- Department of Ophthalmology, Dokkyo Medical University Nikko Medical Center, Nikko 321-2593, Tochigi, Japan
| | - Takahiro Niida
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Ito
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Endo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita 286-8686, Chiba, Japan
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