Utilisation of general practice health assessments around an aged care assessment is associated with lower mortality risk in older Australians
| Autor: | Azmeraw T. Amare, Justin Beilby, Renuka Visvanathan, Maria C.S. Inacio, Steven Lodewyk Wesselingh, Jyoti Khadka, Solomon Yu, Catherine E. Lang |
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| Přispěvatelé: | Visvanathan, Renuka, Amare, Azmeraw T, Lang, Catherine, Khadka, Jyoti, Yu, Solomon, Beilby, Justin, Wesselingh, Steve, Inacio, Maria C |
| Rok vydání: | 2020 |
| Předmět: |
Aging
medicine.medical_specialty National Health Programs aged care General Practice frailty Lower risk older people 03 medical and health sciences 0302 clinical medicine Risk of mortality Medicine Humans 030212 general & internal medicine Aged care Aged Retrospective Studies general practice business.industry 030503 health policy & services Hazard ratio Australia Retrospective cohort study General Medicine Home Care Services Confidence interval Health assessment Family medicine General practice Geriatrics and Gerontology health assessment 0305 other medical science business |
| Zdroj: | Age and ageing. 50(1) |
| ISSN: | 1468-2834 |
| Popis: | Objective (i) to describe the general practitioner utilisation of health assessments, management plans, coordination of team care arrangements and medication review item numbers within 6 months of an aged care eligibility assessment for home care packages (HCP) and (ii) investigate the impact of health assessments on the risk of mortality and entry into permanent residential aged care (PRAC) of individuals accessing HCP. Design and setting retrospective cohort study utilising data from the Registry of Senior Australians (ROSA) was conducted. Subjects 75,172 individuals aged ≥75 years who received HCP between 2011 and 2015. Outcome measure for objective 1: the use of comprehensive assessments (Medicare Benefits Schedule (MBS) items 705 or 707), management plans (MBS 721), coordination of team care arrangements (MBS 723), and medication reviews (MBS 900). For objective 2: time to death and entry into PRAC. Results of the 75,172 individuals, 28.2% (95% confidence interval (CI): 27.8–8.5%) had comprehensive assessments, 36.7% (95% CI: 36.3–37.0%) had management plans, 33.0% (95% CI: 32.7–33.3%) received coordination of team care arrangements and 5.4% (95% CI: 5.2–5.5%) had medication reviews. Individuals with a comprehensive assessment had a 5% lower risk of mortality (adjusted hazard ratio (aHR), 95% CI = 0.95, 0.92–0.98) but 5% higher risk of transition to PRAC (adjusted subdistribution HRs, 95% CI = 1.05, 1.02–1.08) compared to those who did not have these services. Conclusion the utilisation of health assessments was associated with a lower risk of mortality. There is an opportunity for increased use of item numbers in frailer individuals. |
| Databáze: | OpenAIRE |
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