Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/120191
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Type: Journal article
Title: Prolonged wait time prior to entry to home care packages increases the risk of mortality and transition to permanent residential aged care services: findings from the Registry of Older South Australians (ROSA)
Author: Visvanathan, R.
Amare, A.T.
Wesselingh, S.
Hearn, R.
McKechnie, S.
Mussared, J.
Inacio, M.C.
Citation: Journal of Nutrition, Health and Aging, 2019; 23(3):271-280
Publisher: Springer
Issue Date: 2019
ISSN: 1279-7707
1760-4788
Statement of
Responsibility: 
Renuka Visvanathan, A. T. Amare, S. Wesselingh, R. Hearn, S. McKechnie, J. Mussared, M. C. Inacio
Abstract: BACKGROUND:Older Australians prefer to live in their own homes for longer and reforms have attempted to increase the volume of home care packages (HCPs) accordingly but there remains a queue with the longer-term consequences unclear. OBJECTIVES:This study aims to characterise older Australians according to their wait times for a home care package (HCP), evaluate the association between wait time and mortality and evaluate the association between wait time and transition to permanent residential aged care services after HCP. DESIGN:A retrospective cohort study using data from the National Historical cohort (2003-2014) of the Registry of Older South Australians (ROSA) was conducted. SETTING:Home based aged care services, national cohort. METHODS:Wait time was estimated from approval date to date of receiving a HCP. Descriptive, survival estimates (95% confidence intervals (CIs)), and multivariable survival analyses (Cox-regression) were conducted to evaluate the risk of mortality and transition to permanent residential aged care services by quartiles of wait time for HCP. RESULTS:The cohort was followed for 4.0 years (interquartile range IQR (1.8-7.2)) and 38% were alive at the end of the study period with a median wait time for HCP of 62 (21-187) days. From 178,924 older people who received a HCP during the study period (2003-2013), 33.2% people received HCP within 30 days, 74.3% within 6 months and 25.7% after 6 months. The effect of wait time on risk of mortality was time-dependent, with longer wait times associated with higher mortality in the longer term. Compared to people who waited ≤30 days for a HCP, individuals who waited more than 6 months had an almost 20% excess risk of death (adjusted hazard ratio (aHR), 95%CI = (1.18, 1.16-1.21)) 2 years after entry into a HCP. Those who waited more than 6 months also had a 10% (1.10, 1.06-1.13) higher risk of transition to permanent residential aged care services after two years. CONCLUSION:Prolonged wait times for HCP is associated with a higher risk of long-term mortality as well as transition to permanent residential aged care. It remains to be seen if a shortening of this wait time translates into better health outcomes.
Keywords: Healthy ageing
aged care
mortality
nursing home
wait time
Rights: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://doi.org/creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
DOI: 10.1007/s12603-018-1145-y
Grant ID: http://purl.org/au-research/grants/nhmrc/1102208
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