Primary and Secondary Care Related Quality Indicators for Dementia Care Among Australian Aged Care Users: National Trends, Risk Factors, and Variation

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dc.contributor.authorRahja, M.
dc.contributor.authorAir, T.
dc.contributor.authorAhern, S.
dc.contributor.authorWard, S.A.
dc.contributor.authorCaughey, G.E.
dc.contributor.authorSluggett, J.K.
dc.contributor.authorCations, M.
dc.contributor.authorLin, X.
dc.contributor.authorWallis, K.
dc.contributor.authorCrotty, M.
dc.contributor.authorInacio, M.C.
dc.date.issued2022
dc.description.abstractBackground: Studies related to clinical quality indicators (CQIs) in dementia have focused on hospitalizations, medication management, and safety. Less attention has been paid to indicators related to primary and secondary care. Objective: To evaluate the incidence of primary and secondary care CQIs for Australians with dementia using governmentsubsidized aged care. The examined CQIs were: comprehensive medication reviews, 75+ health assessments, comprehensive geriatric assessments, chronic disease management plans, general practitioner (GP) mental health treatment plans, and psychiatrist attendances. Methods: Retrospective cohort study (2011–2016) of 255,458 individuals. National trend analyses estimated incidence rates and 95% confidence intervals (CI) using Poisson or negative binomial regression. Associations were assessed using backward stepwise multivariate Poisson or negative binomial regression model, as appropriate. Funnel plots examined geographic and permanent residential aged care (PRAC) facility variation. Results: CQI incidence increased in all CQIs but medication reviews. For the overall cohort, 75+ health assessments increased from 1.07/1000 person-days to 1.16/1000 person-days (adjusted incidence rate ratio (aIRR) = 1.03, 95%CI 1.02–1.03). Comprehensive geriatric assessments increased from 0.24 to 0.37/1000 person-days (aIRR = 1.12, 95%CI 1.10–1.14). GP mental health treatment plans increased from 0.04 to 0.07/1000 person-days (aIRR = 1.13, 95%CI 1.12–1.15). Psychiatric attendances increased from 0.09 to 0.11/1000 person-days (aIRR = 1.05, 95%CI 1.03–1.07). Being female, older, having fewer comorbidities, and living outside a major city were associated with lower likelihood of using the services. Large geographical and PRAC facility variation was observed (0–92%). Conclusion: Better use of primary and secondary care services to address needs of individuals with dementia is urgently needed.
dc.description.statementofresponsibilityMiia Rahja, Tracy Air, Susannah Ahern, Stephanie A. Ward, Gillian E. Caughey, Janet K. Sluggett, Monica Cations, Xiaoping Lin, Kasey Wallis, Maria Crotty and Maria C. Inacio
dc.identifier.citationJournal of Alzheimer's Disease, 2022; 88(4):1511-1522
dc.identifier.doi10.3233/JAD-220336
dc.identifier.issn1387-2877
dc.identifier.issn1875-8908
dc.identifier.orcidCaughey, G.E. [0000-0003-1192-4121]
dc.identifier.urihttps://hdl.handle.net/2440/138037
dc.language.isoen
dc.publisherIOS Press
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1152623
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT119378
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1156439
dc.rights© 2022 – IOS Press. All rights reserved.
dc.source.urihttps://doi.org/10.3233/jad-220336
dc.subjectDementia; health care; health services for the aged; primary health care; quality indicators; secondary care
dc.subject.meshHumans
dc.subject.meshDementia
dc.subject.meshRisk Factors
dc.subject.meshRetrospective Studies
dc.subject.meshAged
dc.subject.meshQuality Indicators, Health Care
dc.subject.meshAustralia
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshSecondary Care
dc.titlePrimary and Secondary Care Related Quality Indicators for Dementia Care Among Australian Aged Care Users: National Trends, Risk Factors, and Variation
dc.typeJournal article
pubs.publication-statusPublished

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