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|Title:||Clustered domestic residential aged care in australia: fewer hospitalisations and better quality of life|
|Citation:||Medical Journal of Australia, 2018; 208(10):433-438|
|Publisher:||Australasian Medical Publishing Company|
|Suzanne M Dyer, Enwu Liu, Emmanuel S Gnanamanickam, Rachel Milte, Tiffany Easton, Stephanie L Harrison, Clare E Bradley, Julie Ratcliffe and Maria Crotty|
|Abstract:||Objective: To compare the outcomes and costs of clustered domestic and standard Australianmodels of residential aged care. Design: Cross-sectional retrospective analysis of linked health service data, January 2015 e 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, 0.028e0.186; P ¼ 0.008), lower hospitalisation rates (adjusted rate ratio, 0.32; 95% CI, 0.13e0.79; P ¼ 0.010), and lower emergency department presentation rates (adjusted rate ratio, 0.27; 95% CI, 0.14e0.53; 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 facilityrelated factors, it was estimated that overall there is a saving of $12 962 (2016 values; 95% CI, $11 092e14 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.|
|Keywords:||Aged; Economics, medical; Health services for the aged; Quality of life; Resource allocation|
|Rights:||© 2018 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.|
|Appears in Collections:||Public Health publications|
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