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Inacio MC, Amare AT, Whitehead C, Bray SCE, Corlis M, Visvanathan R, Wesselingh S. Factors associated with accessing aged care services in Australia after approval for services: Findings from the historical cohort of the Registry of Senior Australians. Australas J Ageing 2020; 39:e382-e392. [PMID: 31975527 PMCID: PMC7687099 DOI: 10.1111/ajag.12760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 09/26/2019] [Accepted: 11/18/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the access of approved aged care services and factors associated with accessing these services. METHODS A retrospective cohort study was conducted (1/7/2003-30/6/2013). The incidence of accessing permanent residential, home and respite care services within one year or transition care within 28 days of approval was evaluated. The association of participants' socio-demographic characteristics, limitations, health conditions and assessment characteristics with service use was evaluated. RESULTS In 799 750 older Australians, the incidence of accessing approved permanent residential care within one year was 70.9% (95% confidence interval [CI] 70.8%-71.0%), home care 49.5% (95% CI 49.3%-49.7%) and respite 41.8% (95% CI 41.7%-41.9%). The incidence of accessing transition care at 28 days was 78.5% (95% CI 78.2%-78.7%). Aged care seekers', assessments' and assessors' characteristics are associated with service access. CONCLUSION Monitoring the use of aged care service approvals is necessary for the identification of service access barriers to support evidence-based policy changes.
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Affiliation(s)
- Maria C Inacio
- Healthy Ageing Research Consortium, Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Azmeraw T Amare
- Healthy Ageing Research Consortium, Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Craig Whitehead
- Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Sarah C E Bray
- Healthy Ageing Research Consortium, Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | | | - Renuka Visvanathan
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, University of Adelaide, Adelaide, SA, Australia.,Adelaide Geriatrics Training and Research with Aged Care Centre, School of Medicine, University of Adelaide, Adelaide, SA, Australia.,Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Steve Wesselingh
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
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Ko M, Newcomer RJ, Bindman AB, Kang T, Hulett D, Spetz J. Changing home care aides: Differences between family and non-family care in California Medicaid home and community-based services. Home Health Care Serv Q 2019; 39:1-16. [PMID: 31826707 DOI: 10.1080/01621424.2019.1701601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In California Medicaid home-and-community-based services (HCBS), recipients' family members receive payment as home care aides (HCAs). We analyzed data on first-time HCBS recipients to examine factors associated with the likelihood of switching HCAs within the first year of services. Those with family HCAs were less than half as likely to change than those with non-family HCAs and racial/ethnic minorities with non-family HCAs had the highest switching rates. Lower wages and local unemployment were associated with switching of non-family HCAs but not family HCAs. Policymakers can foster continuity of home care by paying family members for home care and raising worker wages.
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Affiliation(s)
- Michelle Ko
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, USA
| | - Robert J Newcomer
- Department of Public Health Sciences, University of California, San Francisco, USA
| | - Andrew B Bindman
- Department of Public Health Sciences, University of California, San Francisco, USA
| | - Taewoon Kang
- Department of Public Health Sciences, University of California, San Francisco, USA
| | - Denis Hulett
- California Medicaid Research Institute, University of California, San Francisco, USA
| | - Joanne Spetz
- Department of Public Health Sciences, University of California, San Francisco, USA
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