4.7 Article

Aged and Health Care Service Utilization by Older Australians Receiving Home Care Packages

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2022.11.019

Keywords

Home care packages; hospitalization; aged care services; emergency department presentation

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This study examined the cohort of individuals receiving Home Care Packages (HCPs) in Australia in 2016, their access to other aged care services, and their utilization of hospital and ambulance services. The findings show that HCP recipients have frequent hospitalizations, with emergency department presentations being the most common, and a significant proportion of them accessing respite care and transitioning to permanent residential care each year.
Objectives: To examine the (1) cohort of individuals living at home with Home Care Packages (HCPs) in 2016, (2) their access to other aged care services after HCP commencement, and (3) their hospital and ambulance service utilization.Design: A cross-sectional study was conducted using integrated aged care and health care data contained within the National Historical Cohort of the Registry of Senior Australians. Setting and Participants: This study included people who accessed HCP between January 1, 2016 and December 31, 2016.Methods: The access to permanent residential aged care, transition care, respite care, hospital and ambulance services among Australian HCP recipients >= 65 years old in 2016 was evaluated. Descriptive statistics were employed.Results: In 2016, 84,681 individuals received HCPs, of which 68.4% (n = 57,942) accessed HCP levels 1-2, 26.0% (n = 22,057) accessed HCP levels 3-4, and 5.5% (n = 4682) accessed both care levels within the year. Of the individuals receiving HCP, 34.0% (n = 27,787) started services that year and 16.7% (n =14,117) moved to permanent residential aged care, 18.4% (n =15,592) used respite care and 5.8% (n = 4937) used transition care that year. Emergency department (ED) presentations [43.6%, 95% confidence interval (CI) 43.3-4 4.0] were the most common hospital encounters, followed by inpatient hospitalizations for any reason (43.3%, 95% CI 42.9-43.7), and unplanned hospitalizations (38%, 95% CI 37.6-38.3). Forty-four percent (4 4.5%, 95% CI 43.9-45.0) of individuals utilized ambulance services. ED presentations, hospi-talization for any reason, and unplanned hospitalizations were more common in individuals receiving HCP levels 3-4 compared with those accessing HCP levels 1-2.Conclusions and Implications: HCP recipients in Australia have frequent hospitalizations, including ED presentations. In addition, almost 1 in 5 access respite care and 16.7% transition to permanent residential care each year. As the population accessing HCP is increasing, adequate support for these individuals to live well at home and avoid health events that lead to hospitalizations are necessary. (c) 2022 AMDA -The Society for Post-Acute and Long-Term Care Medicine.

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