Insights from linking routinely collected data across Australian health jurisdictions: a case study of end-of-life health service use

Abstract

Objectives: The jurisdictional nature of routinely collected health data in Australia has created challenges for linking data across state/territory and federal government boundaries. This has impeded understanding of the interplay between service use across hospital and community care. Our objective was to demonstrate the value-add of cross-jurisdictional data using a case study of health service use and the factors associated with healthcare use towards the end of life.Study type: Retrospective cohort study using routinely collected health data. Methods:We used two decedent cohorts of people aged ≥65 years who died in New South Wales (NSW), Australia, in 2006 or 2007. The population cohort comprised the general NSW population linked to NSW data collections; the other cohort comprised Australian Government Department of Veterans' Affairs (DVA) clients (with full healthcare entitlements) linked to NSW and Commonwealth data. We compared information available on health services received during the last 6 months of life and ran multivariable analyses for both cohorts to demonstrate the added value of the Commonwealth data. Results:We included 37 567 decedents in the population cohort and 11 259 in the DVA cohort. Cancer was the cause of death for 27% of the NSW cohort and 22% of the DVA cohort; approximately 40% of decedents in each cohort had a cancer history. We summarise information on hospital services for both cohorts and examine community care (general practitioner consultations, specialist presentations, prescriptions dispensed) for the DVA cohort only. Multivariable analyses in the DVA cohort demonstrated that high rates of emergency department (ED) presentations and hospitalisation were associated with higher rates of use of all health services, including

Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study

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End‐of‐life care in rural and regional Australia: Patients’, carers’ and general practitioners’ expectations of the role of general practice, and the degree to which they were met

“…In Australia, as well as internationally, there are barriers to hospital–community data sharing. Information sharing is of particular concern for both services when caring for patients who are frequently hospitalised at the EOL, and for whom rapid access to information is required to provide seamless and timely care (Langton et al., 2018). Poor interprofessional communication also limits GPs’ access to accurate information and their ability to provide optimal, coordinated care (McConnell, Butow, & Tattersall, 1999; O’Malley & Reschovsky, 2011).…”

Developing new ways of measuring the quality and impact of ambulance service care: the PhOEBE mixed-methods research programme

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