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Clune S, Rayner J, McAuliffe L, Fetherstonhaugh D. A snapshot of social activities programs in residential aged care facilities in Victoria: A brief report. Australas J Ageing 2023; 42:592-597. [PMID: 37726923 DOI: 10.1111/ajag.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To capture current opportunities for social participation for older people living in residential aged care in Victoria, Australia. METHODS A postal survey of all 766 Victorian residential aged care facilities. Respondents were asked to outline the nature of social participation opportunities available to residents, any potential barriers to inclusion and organisational commitments such as funding allocations and staff fractions. RESULTS Surveys were returned by 153 facilities, representing a response rate of 20%. All facilities had a dedicated social program, although just over half (57%; 87 of 153) offered the social program over the weekend, usually on a Saturday morning only (90%). Barriers to older people's opportunities for social participation included their ineligibility to continue attending external community programs once entering residential aged care (86%), their illness (71%), carer availability (50%) and lack of funding (42%). Funding for almost all programs (128 of 153; 84%) was described as internal and ad hoc, and staff allocations for the program were almost entirely fractional. Only 12 (8%) facilities reported that they had a dedicated full-time coordinator for the social participation program. CONCLUSIONS Social participation programs are available in Victorian residential aged care facilities. However, limited funding and staff allocations reduce the opportunities for older people to engage in meaningful social participation with others.
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Affiliation(s)
- Samantha Clune
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Victoria, Australia
| | - Jo Rayner
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Victoria, Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Victoria, Australia
| | - Deirdre Fetherstonhaugh
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Victoria, Australia
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LeBlanc M, McGaughey T, Peters PA. Characteristics of High-Resource Health System Users in Rural and Remote Regions: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5385. [PMID: 37047999 PMCID: PMC10094250 DOI: 10.3390/ijerph20075385] [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: 02/10/2023] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
A small proportion of health care users are recognized to use a significantly higher proportion of health system resources, largely due to systemic, inequitable access and disproportionate health burdens. These high-resource health system users are routinely characterized as older, with multiple comorbidities, and reduced access to adequate health care. Geographic trends also emerge, with more rural and isolated regions demonstrating higher rates of high-resource use than others. Despite known geographical discrepancies in health care access and outcomes, health policy and research initiatives remain focused on urban population centers. To alleviate mounting health system pressure from high-resource users, their characteristics must be better understood within the context in which i arises. To examine this, a scoping review was conducted to provide an overview of characteristics of high-resource users in rural and remote communities in Canada and Australia. In total, 21 papers were included in the review. Using qualitative thematic coding, primary findings characterized rural high-resource users as those of an older age; with increased comorbid conditions and condition severity; lower socioeconomic status; and elevated risk behaviors.
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Affiliation(s)
- Michele LeBlanc
- School of Nursing, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Tomoko McGaughey
- Department of Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Paul A. Peters
- Department of Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
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Jayakody A, Oldmeadow C, Carey M, Bryant J, Evans T, Ella S, Attia J, Towle S, Sanson-Fisher R. Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic conditions in New South Wales, Australia: a historical cohort study. BMC Health Serv Res 2020; 20:1082. [PMID: 33238996 PMCID: PMC7690010 DOI: 10.1186/s12913-020-05950-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander people have high rates of avoidable hospital admissions for chronic conditions, however little is known about the frequency of avoidable admissions for this population. This study examined trends in avoidable admissions among Aboriginal and non-Aboriginal people with chronic conditions in New South Wales (NSW), Australia. METHODS A historical cohort analysis using de-identified linked administrative data of Aboriginal patients and an equal number of randomly sampled non-Aboriginal patients between 2005/06 to 2013/14. Eligible patients were admitted to a NSW public hospital and who had one or more of the following ambulatory care sensitive chronic conditions as a principal diagnosis: diabetic complications, asthma, angina, hypertension, congestive heart failure and/or chronic obstructive pulmonary disease. The primary outcomes were the number of avoidable admissions for an individual in each financial year, and whether an individual had three or more admissions compared with one to two avoidable admissions in each financial year. Poisson and logistic regression models and a test for differences in yearly trends were used to assess the frequency of avoidable admissions over time, adjusting for sociodemographic variables and restricted to those aged ≤75 years. RESULTS Once eligibility criteria had been applied, there were 27,467 avoidable admissions corresponding to 19,025 patients between 2005/06 to 2013/14 (71.2% Aboriginal; 28.8% non-Aboriginal). Aboriginal patients were 15% more likely than non-Aboriginal patients to have a higher number of avoidable admissions per financial year (IRR = 1.15; 95% CI: 1.11, 1.20). Aboriginal patients were almost twice as likely as non-Aboriginal patients to experience three or more avoidable admissions per financial year (OR = 1.90; 95% CI = 1.60, 2.26). There were no significant differences between Aboriginal and non-Aboriginal people in yearly trends for either the number of avoidable admissions, or whether or not an individual experienced three or more avoidable admissions per financial year (p = 0.859; 0.860 respectively). CONCLUSION Aboriginal people were significantly more likely to experience frequent avoidable admissions over a nine-year period compared to non-Aboriginal people. These high rates reflect the need for further research into which interventions are able to successfully reduce avoidable admissions among Aboriginal people, and the importance of culturally appropriate community health care.
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Affiliation(s)
- Amanda Jayakody
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
| | - Christopher Oldmeadow
- CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, NSW, 2305, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Mariko Carey
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Tiffany Evans
- CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, NSW, 2305, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Stephen Ella
- Nunyara Aboriginal Health Unit, Central Coast Local Health District, Ward Street, Gosford, NSW, 2250, Australia
| | - John Attia
- CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, NSW, 2305, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Simon Towle
- The Cairns Institute, James Cook University, PO Box 6811, Cairns, QLD, 4870, Australia
| | - Robert Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
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di Bella E, Gandullia L, Leporatti L, Locatelli W, Montefiori M, Persico L, Zanetti R. Frequent use of emergency departments and chronic conditions in ageing societies: a retrospective analysis based in Italy. Popul Health Metr 2020; 18:29. [PMID: 33168009 PMCID: PMC7654169 DOI: 10.1186/s12963-020-00237-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Most western countries are facing relevant demographic changes, and the percentage of older people is destined to rise in the next decades. This fact is likely to affect the sustainability of healthcare systems significantly, mainly due to the connected issue of chronicity. Methods In this paper, using an extensive and comprehensive administrative dataset, we analyse the phenomenon of frequent use of emergency departments (ED) in the oldest region in Europe (i.e. Liguria) over 4 years (2013–2016). Two alternative approaches are used to define categories of ED users based on the intensity and frequency of accesses and splitting patients into different age groups. Results Results allow identifying clinical and socio-demographic risk-factors connected to different levels of ED utilisation and highlight the influential role played by chronic conditions (particularly mental disorders, respiratory diseases) and by multiple chronic conditions. Conclusions The study aims at representing an informative tool to support policy-makers in setting proper policies addressed, on the one side, towards the potentially preventable frequent users and, on the other, towards those accessing due to complex medical conditions. The results can help in building a warning system to help general practitioners in the identification of potential frequent users and to develop preventive policies.
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Affiliation(s)
- Enrico di Bella
- Department of Political Sciences, University of Genoa, Piazzale E. Brignole, 3A, 16124, Genoa, Italy
| | - Luca Gandullia
- Department of Political Sciences, University of Genoa, Piazzale E. Brignole, 3A, 16124, Genoa, Italy
| | - Lucia Leporatti
- Department of Economics and Business Studies, University of Genoa, Via Vivaldi 5, 16126, Genoa, Italy.
| | - Walter Locatelli
- A.Li.Sa, Regione Liguria, Piazza della Vittoria, 15, 16121, Genoa, Italy
| | - Marcello Montefiori
- Department of Economics and Business Studies, University of Genoa, Via Vivaldi 5, 16126, Genoa, Italy
| | - Luca Persico
- Department of Economics and Business Studies, University of Genoa, Via Vivaldi 5, 16126, Genoa, Italy
| | - Roberta Zanetti
- A.Li.Sa, Regione Liguria, Piazza della Vittoria, 15, 16121, Genoa, Italy
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Huhtakangas M, Kyngäs H, Bloigu R, Kanste O. Differentiating middle-aged long-term and short-term frequent attenders by means of the Northern Finland Birth Cohort 1966 Study. Scand J Caring Sci 2020; 35:813-823. [PMID: 32740948 DOI: 10.1111/scs.12896] [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: 02/22/2020] [Revised: 06/17/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Frequent attendance is largely a temporary phenomenon, but only few previous studies have made a distinction between long-term frequent attenders (FAs) and short-term FAs. AIMS The aim of this study is to compare the characteristics of middle-aged long-term FAs and short-term FAs. METHODS Data from a large Northern Finland Birth Cohort 1966 study's (NFBC1966) 46-year follow-up study (performed in 2012, N = 10 321) were used. The participants (n = 4390) had used public primary healthcare (PPHC) services at least once during 2013-2016 according to Finnish national register data on outpatient visits. A FA was considered a patient who had used PPHC services ≥8 times during 1 year. A long-term FA: a patient who was a FA in at least 3 years during 2013-2016. A short-term FA: a patient who was a FA in 1 or 2 years in 2013-2016. Cross-tabulation, Pearson's chi-squared test, Mann-Whitney U test, and univariate and multivariate binary logistic regression analyses were used. RESULTS Of the 4390 participants, 132 (3.0%) were long-term FAs, 645 (14.7%) were short-term FAs, and 3613 (82.3%) were non-FAs. During 2013-2016, long-term FAs accounted for 34.8% of PPHC visits, while short-term FAs accounted 15.4%. Compared to short-term FAs, depression and high income (preventive attribute) were associated with long-term FAs. Female gender and managing usual activities were associated with short-term FAs. Poor self-reported health was associated with both long-term FAs and short-term FAs but increased the risk of being a long-term FA over three times compared to short-term FAs. CONCLUSIONS Middle-aged long-term FAs and short-term FAs have distinct characteristics; namely, depression and high income differentiate long-term FAs from short-term FAs. Poor self-reported health was associated with long-term FAs in particular. In order to identify FAs with prolonged service needs and to develop far-reaching interventions, the focus of research should be on long-term FAs.
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Affiliation(s)
- Moona Huhtakangas
- Department of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Helvi Kyngäs
- Department of Nursing Science and Health Management, Faculty of Medicine, Medical Research Centre, University Hospital of Oulu, University of Oulu, Oulu, Finland
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Outi Kanste
- Department of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
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