Trends in the utilisation of aged care services in Australia, 2008–2016

Khadka, Jyoti; Lang, Catherine; Ratcliffe, Julie; Corlis, Megan; Wesselingh, Steven; Whitehead, Craig; Inacio, Maria C.S.

doi:10.1186/s12877-019-1209-9

Cited by 65 publications

(63 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our cohort captures a nationally representative sample of individuals accessing aged care services for which an aged care eligibility assessment is required in Australia; in the 2015-2016 financial year, the number of individuals accessing these services was, approximately 5.6% of the population >65 years of age. 46 Our study relied on the systematic data collection that occurs as part of the comprehensive eligibility assessments performed in Australia for all individuals accessing aged care services; these assessments are performed by trained assessors. Additionally, our cohort contained the age range that is most at risk for cataract and skin cancer.…”

Section: Discussionmentioning

confidence: 99%

Association of Age-Related Cataract With Skin Cancer in an Australian Population

Sharma

Lang

Khadka

et al. 2020

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

Ultraviolet radiation from sunlight contributes to age-related cataract and skin cancer. The EPHA2 gene is implicated in both these diseases. The purpose of this study was to determine whether age-related cataract and skin cancer are associated in a cohort of older Australians. METHODS. A cross-sectional study was performed using the Historical Cohort of the Registry of Senior Australians. Individuals aged ≥65 years or aged ≥50 years and of Aboriginal or Torres Strait Islander descent, who had an aged care eligibility assessment between July 2005 and June 2015, and had a history of cataract surgery and/or skin cancer according to the Australian Government Medicare Benefits Schedule dataset, during the 3-year period prior, were evaluated (N = 599,316). A multivariable logistic regression model was used to determine association and multiple hypothesis correction was employed. RESULTS. Of the evaluated individuals, 87,097 (14.5%) had a history of cataract and 170,251 (28.4%) a history of skin cancer. Among those with a history of cataract, 20,497 (23.5%), 1127 (1.3%), and 14,730 (16.9%) individuals had a concurrent history of keratinocyte, melanoma, and premalignant/solar keratosis, respectively. Those with a history of cataract were 19% more likely to have a history of skin cancer (odds ratio [OR], 1.19; 95% confidence interval [CI], (1.17-1.21). Co-occurrence of keratinocyte skin cancer was 16% (OR, 1.16; 95% CI, 1.14-1.18), melanoma 21% (OR, 1.21; 95% CI, 1.13-1.29), and premalignant/solar keratosis 19% (OR, 1.19; 95% CI, 1.17-1.22) more in the presence than absence of history of cataract. CONCLUSIONS. Age-related cataract is positively associated with skin cancer and its subtypes, including premalignant lesions in an older Australian population.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of Age-Related Cataract With Skin Cancer in an Australian Population

Sharma

Lang

Khadka

et al. 2020

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is apparent that older Australians prefer to live in their own homes for longer, closer to family and their community, continue to participate as well as contribute and have a major say in what happens to them ( 2 , 3 ). In line with their preference, reform to the Australian aged care system has occurred progressively over the last two decades including through a series of 2013 amendments to the Aged Care Act 1997 when the government increased user choice and control of aged care services delivered at home.…”

Section: Introductionmentioning

confidence: 99%

Prolonged Wait Time Prior to Entry to Home Care Packages Increases the Risk of Mortality and Transition to Permanent Residential Aged Care Services: Findings from the Registry of Older South Australians (ROSA)

Visvanathan

Amare

Wesselingh

et al. 2019

The Journal of nutrition, health and aging

View full text Add to dashboard Cite

Background Older Australians prefer to live in their own homes for longer and reforms have attempted to increase the volume of home care packages (HCPs) accordingly but there remains a queue with the longer-term consequences unclear. Objectives This study aims to characterise older Australians according to their wait times for a home care package (HCP), evaluate the association between wait time and mortality and evaluate the association between wait time and transition to permanent residential aged care services after HCP. Design A retrospective cohort study using data from the National Historical cohort (2003-2014) of the Registry of Older South Australians (ROSA) was conducted. Setting Home based aged care services, national cohort. Methods Wait time was estimated from approval date to date of receiving a HCP. Descriptive, survival estimates (95% confidence intervals (CIs)), and multivariable survival analyses (Cox-regression) were conducted to evaluate the risk of mortality and transition to permanent residential aged care services by quartiles of wait time for HCP. Results The cohort was followed for 4.0 years (interquartile range IQR (1.8-7.2)) and 38% were alive at the end of the study period with a median wait time for HCP of 62 (21-187) days. From 178,924 older people who received a HCP during the study period (2003-2013), 33.2% people received HCP within 30 days, 74.3% within 6 months and 25.7% after 6 months. The effect of wait time on risk of mortality was time-dependent, with longer wait times associated with higher mortality in the longer term. Compared to people who waited ≤30 days for a HCP, individuals who waited more than 6 months had an almost 20% excess risk of death (adjusted hazard ratio (aHR), 95%CI = (1.18, 1.16-1.21)) 2 years after entry into a HCP. Those who waited more than 6 months also had a 10% (1.10, 1.06-1.13) higher risk of transition to permanent residential aged care services after two years. Conclusion Prolonged wait times for HCP is associated with a higher risk of long-term mortality as well as transition to permanent residential aged care. It remains to be seen if a shortening of this wait time translates into better health outcomes. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/s12603-018-1145-y and is accessible for authorized users.

show abstract

“…Older people are choosing to remain in their own homes longer; consequently, the proportion with high level care needs entering aged care increased fourfold between 2009 (13%) and 2018 (53%). 14,15 While the number of home care packages provided by the Australian government to support older people living at home has increased, demand continues to exceed supply. During 2005-2006, 7% of aged care recipients had waited longer than nine months for home care packages.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a frailty index based on Australian Aged Care Assessment Program data

Khadka

Visvanathan

Theou

et al. 2020

Medical Journal of Australia

Self Cite

View full text Add to dashboard Cite

Frailty is the consequence of cumulative declines in multiple physiological systems during life, resulting in impaired homeostasis and vulnerability to acute stressors. 1 It is associated with adverse health outcomes, including falls, dependency, hospitalisation, and death. 1,2 With timely interventions, the consequences of frailty can be ameliorated, and screening may identify risk and facilitate assistance that meets individual needs. 3,4 A frailty index can be used to predict the risk of adverse health outcomes. Frailty index scores can be generated when comprehensive geriatric health assessments have been undertaken, especially if supported by electronic systems, as is the case in England for general practice. 5 Since 2003, the care needs of frail older Australians have been comprehensively assessed in the multidisciplinary Aged Care Assessment Program (ACAP), assisting them gain access to appropriate care for improving their health and wellbeing. 6 The assessment, completed by trained and certified assessors, 7 does not specifically measure frailty, but the electronic record of the assessment could facilitate automated generation of a frailty index score. In our study, we accordingly developed and validated a frailty index based on ACAP data. Methods We constructed a frailty index based on de-identified data for the historical cohort of the Registry of Senior Australians (ROSA) 8,9 and conducted a retrospective cohort study. We analysed linked ACAP and community and residential aged care services data and National Death Index data included in the ROSA (obtained from the Australian Institute of Health and Welfare 10). The ACAP dataset includes the demographic characteristics, service approvals, health conditions, and activity limitations of assessed older people collected in eligibility assessments by multidisciplinary Aged Care Assessment Teams (ACAT; in Victoria: Aged Care Assessment Services).

show abstract

Trends in the utilisation of aged care services in Australia, 2008–2016

Cited by 65 publications

References 16 publications

Association of Age-Related Cataract With Skin Cancer in an Australian Population

Association of Age-Related Cataract With Skin Cancer in an Australian Population

Prolonged Wait Time Prior to Entry to Home Care Packages Increases the Risk of Mortality and Transition to Permanent Residential Aged Care Services: Findings from the Registry of Older South Australians (ROSA)

Development and validation of a frailty index based on Australian Aged Care Assessment Program data

Contact Info

Product

Resources

About