OBJECTIVE: To compare the outcomes and costs of clustered domestic and standard Australian models of residential aged care. DESIGN: Cross-sectional retrospective analysis of linked health service data, January 2015 - February 2016. SETTING: 17 aged care facilities in four Australian states providing clustered (four) or standard Australian (13) models of residential aged care. PARTICIPANTS: People with or without cognitive impairment residing in a residential aged care facility (RACF) for at least 12 months, not in palliative care, with a family member willing to participate on their behalf if required. 901 residents were eligible; 541 consented to participation (24% self-consent, 76% proxy consent). MAIN OUTCOME MEASURES: Quality of life (measured with EQ-5D-5L); medical service use; health and residential care costs. RESULTS: After adjusting for patient- and facility-level factors, individuals residing in clustered models of care had better quality of life (adjusted mean EQ-5D-5L score difference, 0.107; 95% CI, 0.028-0.186; P = 0.008), lower hospitalisation rates (adjusted rate ratio, 0.32; 95% CI, 0.13-0.79; P = 0.010), and lower emergency department presentation rates (adjusted rate ratio, 0.27; 95% CI, 0.14-0.53; P < 0.001) than residents of standard care facilities. Unadjusted facility running costs were similar for the two models, but, after adjusting for resident- and facility-related factors, it was estimated that overall there is a saving of $12 962 (2016 values; 95% CI, $11 092-14 831) per person per year in residential care costs. CONCLUSIONS: Clustered domestic models of residential care are associated with better quality of life and fewer hospitalisations for residents, without increasing whole of system costs.
OBJECTIVE: To compare the outcomes and costs of clustered domestic and standard Australian models of residential aged care. DESIGN: Cross-sectional retrospective analysis of linked health service data, January 2015 - February 2016. SETTING: 17 aged care facilities in four Australian states providing clustered (four) or standard Australian (13) models of residential aged care. PARTICIPANTS: People with or without cognitive impairment residing in a residential aged care facility (RACF) for at least 12 months, not in palliative care, with a family member willing to participate on their behalf if required. 901 residents were eligible; 541 consented to participation (24% self-consent, 76% proxy consent). MAIN OUTCOME MEASURES: Quality of life (measured with EQ-5D-5L); medical service use; health and residential care costs. RESULTS: After adjusting for patient- and facility-level factors, individuals residing in clustered models of care had better quality of life (adjusted mean EQ-5D-5L score difference, 0.107; 95% CI, 0.028-0.186; P = 0.008), lower hospitalisation rates (adjusted rate ratio, 0.32; 95% CI, 0.13-0.79; P = 0.010), and lower emergency department presentation rates (adjusted rate ratio, 0.27; 95% CI, 0.14-0.53; P < 0.001) than residents of standard care facilities. Unadjusted facility running costs were similar for the two models, but, after adjusting for resident- and facility-related factors, it was estimated that overall there is a saving of $12 962 (2016 values; 95% CI, $11 092-14 831) per person per year in residential care costs. CONCLUSIONS: Clustered domestic models of residential care are associated with better quality of life and fewer hospitalisations for residents, without increasing whole of system costs.
Entities:
Keywords:
Aged; Economics, medical; Health services for the aged; Quality of life; Resource allocation
Authors: Stephanie L Harrison; Suzanne M Dyer; Kate E Laver; Rachel K Milte; Richard Fleming; Maria Crotty Journal: Cochrane Database Syst Rev Date: 2022-03-07
Authors: Peter D Hibbert; Louise K Wiles; Ian D Cameron; Alison Kitson; Richard L Reed; Andrew Georgiou; Len Gray; Johanna Westbrook; Hanna Augustsson; Charlotte J Molloy; Gaston Arnolda; Hsuen P Ting; Rebecca Mitchell; Frances Rapport; Susan J Gordon; William B Runciman; Jeffrey Braithwaite Journal: BMJ Open Date: 2019-06-25 Impact factor: 2.692
Authors: Emmanuel S Gnanamanickam; Suzanne M Dyer; Rachel Milte; Enwu Liu; Julie Ratcliffe; Maria Crotty Journal: Int J Qual Health Care Date: 2019-07-01 Impact factor: 2.038