Maria C Inacio1,2, Catherine Lang1, Sarah C E Bray1,2,3, Renuka Visvanathan4,5,6, Craig Whitehead7,8, Elizabeth C Griffith9, Keith Evans1, Megan Corlis10, Steve Wesselingh11. 1. Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. 2. Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. 3. Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 4. National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia. 5. Adelaide Geriatrics Training and Research with Aged Care Centre, University of Adelaide, Adelaide, South Australia, Australia. 6. Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia. 7. Division of Rehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia. 8. Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia. 9. Clinical Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. 10. Research and Development, Helping Hand Aged Care, Adelaide, South Australia, Australia. 11. South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Understanding the health profile, service and medicine use of Australians in the aged care sector will help inform appropriate service provision for our ageing population. AIMS: To examine the 2006-2015 trends in (i) comorbidities and frailty of individuals accessing aged care, and (ii) health services, medicine use and mortality after entry into long-term care. METHODS: Cross-sectional and population-based trend analyses were conducted using the Registry of Senior Australians. RESULTS: From 2006 to 2015, 509 944 individuals accessed permanent residential care, 206 394 home care, 283 014 respite and 124 943 transition care. Over this time, the proportion of individuals accessing permanent residential care with high frailty scores (≥0.3) increased (19.7-49.7%), as did the proportion with 5-9 comorbidities (46.4-54.5%), with similar trends observed for those accessing other services. The median number of medicines dispensed in the year after entering permanent residential care increased from 9 (interquartile range (IQR) 6-12) to 10 (IQR 7-14), while remaining stable in home care (2006: 9, IQR 5-12, 2015: 9, IQR 6-13). Short-term (within 100 days) mortality in those accessing permanent care was higher in 2006 (15.6%, 95% CI 15.2-16.0) than 2015 (14.6%, 95% CI 14.3-14.9). Longer term (101-1095 days, 2006: 44.3%, 95% CI 43.7-45.0, 2015: 46.4%, 95% CI 45.8-46.9) mortality was higher in 2015 compared to 2006. Mortality in individuals accessing home care did not change. CONCLUSION: The health of older Australians accessing aged care programmes has declined while frailty increased, with an increasing use of medicine and worse long-term mortality in some. Funding and care models need to adapt to this changing profile.
BACKGROUND: Understanding the health profile, service and medicine use of Australians in the aged care sector will help inform appropriate service provision for our ageing population. AIMS: To examine the 2006-2015 trends in (i) comorbidities and frailty of individuals accessing aged care, and (ii) health services, medicine use and mortality after entry into long-term care. METHODS: Cross-sectional and population-based trend analyses were conducted using the Registry of Senior Australians. RESULTS: From 2006 to 2015, 509 944 individuals accessed permanent residential care, 206 394 home care, 283 014 respite and 124 943 transition care. Over this time, the proportion of individuals accessing permanent residential care with high frailty scores (≥0.3) increased (19.7-49.7%), as did the proportion with 5-9 comorbidities (46.4-54.5%), with similar trends observed for those accessing other services. The median number of medicines dispensed in the year after entering permanent residential care increased from 9 (interquartile range (IQR) 6-12) to 10 (IQR 7-14), while remaining stable in home care (2006: 9, IQR 5-12, 2015: 9, IQR 6-13). Short-term (within 100 days) mortality in those accessing permanent care was higher in 2006 (15.6%, 95% CI 15.2-16.0) than 2015 (14.6%, 95% CI 14.3-14.9). Longer term (101-1095 days, 2006: 44.3%, 95% CI 43.7-45.0, 2015: 46.4%, 95% CI 45.8-46.9) mortality was higher in 2015 compared to 2006. Mortality in individuals accessing home care did not change. CONCLUSION: The health of older Australians accessing aged care programmes has declined while frailty increased, with an increasing use of medicine and worse long-term mortality in some. Funding and care models need to adapt to this changing profile.
Authors: Janet K Sluggett; Gillian E Caughey; Tracy Air; Max Moldovan; Catherine Lang; Grant Martin; Stephen R Carter; Shane Jackson; Andrew C Stafford; Steve L Wesselingh; Maria C Inacio Journal: Age Ageing Date: 2022-07-01 Impact factor: 12.782
Authors: Janet K Sluggett; Gillian E Caughey; Tracy Air; Max Moldovan; Catherine Lang; Grant Martin; Stephen R Carter; Shane Jackson; Andrew C Stafford; Steve L Wesselingh; Maria C Inacio Journal: BMC Geriatr Date: 2022-06-08 Impact factor: 4.070
Authors: Maria C Inacio; Robert N Jorissen; Steve Wesselingh; Janet K Sluggett; Craig Whitehead; John Maddison; John Forward; Alice Bourke; Gillian Harvey; Maria Crotty Journal: BMJ Open Date: 2021-11-17 Impact factor: 3.006
Authors: Maria C Inacio; Max Moldovan; Craig Whitehead; Janet K Sluggett; Maria Crotty; Megan Corlis; Renuka Visvanathan; Steve Wesselingh; Gillian E Caughey Journal: BMC Geriatr Date: 2021-12-07 Impact factor: 3.921