Disease burden, comorbidity and geriatric syndromes in the Australian aged care population

Hillen, Jodie B; Vitry, Agnès; Caughey, Gillian E.

doi:10.1111/ajag.12411

Cited by 39 publications

(44 citation statements)

References 9 publications

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“…before the ACFI). ACAP allows up to ten conditions to be reported, and studies that used ACAP(16) data have found generally higher prevalence rates for conditions than those based on ACFI data, but both sources report generally lower rates than our estimates from EHR data (17). As for survey data, our prevalence estimates for most conditions also tended to be higher; compared to estimates from the Australian Bureau of Statistics Survey of Disability, Ageing and Carers in 2015 for respondents in residential aged care, our prevalence estimates are similar for arthritis, but higher for osteoporosis, anxiety, depression, hypertension and diabetes (20).…”

Section: Discussioncontrasting

confidence: 63%

“…These differences were more pronounced for some conditions. For example, we found higher prevalence rates based on residents' EHR data for the three most common conditions compared to those identified with ACFI data alone: dementia (58% vs. 48%), depression (54% vs. 23%) and arthritis (61% vs. 14%) (17). Our results suggest that ACFI data alone may generally underestimate condition prevalence, but the magnitude of underestimation varies by condition.…”

Section: Discussionmentioning

confidence: 49%

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Measuring the prevalence of 60 health conditions in older Australians in residential aged care with electronic health records: a retrospective dynamic cohort study

Lind

Raban

Brett

et al. 2020

Preprint

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Background : The number of older Australians using aged care services is increasing, yet there is an absence of reliable data on their health. Multimorbidity in this population has not been well described. A clear picture of the health status of people using aged care is essential for informing health practice and policy to support evidence-based, equitable, high-quality care. Our objective was to describe the health status of older Australians living in residential aged care facilities (RACFs) and develop a model for monitoring health conditions using data from electronic health record systems. Methods : Using a dynamic retrospective cohort of 9436 RACF residents living in 68 RACFs in New South Wales and the Australian Capital Territory from 2014-2017, we developed an algorithm to identify residents’ conditions using: aged care funding assessments; medications administered; and clinical notes from their facility electronic health record (EHR). We generated age and sex-specific prevalence estimates for 60 health conditions. Agreement between conditions recorded in aged care funding assessments and those documented in residents’ EHRs was evaluated using Cohen’s Kappa. Cluster analysis was used to describe combinations of health conditions (multimorbidity) occurring among residents. Results : Using all data sources, 93% of residents had some form of circulatory disease, with hypertension the most common (62%). Most residents (93%) had a mental or behavioural disorder, including dementia (58%) or depression (54%). For most conditions, EHR data identified approximately twice the number of people with the condition compared to aged care funding assessments. Agreement between data sources was highest for multiple sclerosis, Huntington’s disease and dementia. The cluster analysis identified seven groups with distinct combinations of health conditions and demographic characteristics and found that the most complex cluster represented a group of residents that had on average the longest lengths of stay in residential care. Conclusions : The prevalence of many health conditions among RACF residents in Australia is underestimated in previous reports. Aged care EHR data have the potential to be used to better understand the complex health needs of this vulnerable population and can help fill the information gaps needed for population health surveillance and quality monitoring.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 49%

Measuring the prevalence of 60 health conditions in older Australians in residential aged care with electronic health records: a retrospective dynamic cohort study

Lind

Raban

Brett

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Most people entering RACS require 24‐hour care and support: 60% need assistance with feeding, dressing, personal hygiene and mobility; 72.1% have high needs related to dementia behaviours; and 61.3% have complex health‐care needs including chronic illnesses such as dementia. These illnesses severely impact on individual care needs and functional ability . The projected doubling of Australians aged ≥85 years plus over the next two decades will drive the demand for residential aged care .…”

Section: Introductionmentioning

confidence: 99%

“…These illnesses severely impact on individual care needs and functional ability. 4 The projected doubling of Australians aged ≥85 years plus over the next two decades will drive the demand for residential aged care. 5 Ideally, the provision of evidence-based aged care should be built on rigorous research involving both residents and staff.…”

mentioning

confidence: 99%

Research priorities in residential aged care services: A statewide survey

2019

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Objectives To ascertain the research priorities of staff working in Victorian residential aged care services (RACS). Method In October 2016, all 754 Victorian RACS were asked to list three most important research priorities in a confidential postal survey. Descriptive statistics and content analysis were used to analyse the data. Results One hundred and sixty‐two (21.5%) RACS participated. Research priorities, in order of importance, were grouped thematically as workforce issues, strategies to manage residents with dementia and funding to the sector. Staffing numbers and mix, particularly nurse‐to‐resident ratios, dominated workforce issues. The management of responsive behaviours was highlighted as a pressing clinical issue, and insufficient funding to the sector impacted on most issues reported. Conclusions The research priorities identified were inter‐related. Some were already well researched, suggesting RACS staff have little time and/or limited access to research evidence to inform the care and management of residents, possibly because of inadequate staffing and funding.

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“…More than half of the papers in this virtual issue highlight the care and system needs for people with dementia. For example, Hillen et al highlight that there are 170 000 Australians living in aged care facilities, but limited understanding of the disease burden in this group. They review ACFI data for 169 000 residents, finding a high level of complex morbidities, with dementia, depression and circulatory disease, the most prevalent conditions in patterns of comorbidity.…”

mentioning

confidence: 99%