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General practitioner conduct of clinical services representing comprehensive geriatric assessment is associated with lower risk of mortality in older Australians receiving home care packages

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dc.contributor.authorVisvanathan, R.
dc.contributor.authorAmare, A.T.
dc.contributor.authorWesselingh, S.
dc.contributor.authorInacio, M.C.
dc.date.issued2021
dc.description.abstractOBJECTIVES: The purpose of this paper is to investigate the utilisation of general practice Medicare Benefit Schedule (MBS) services aligned to Comprehensive Geriatric Assessment (CGA) within 6 months of an aged care eligibility assessment and its effects on mortality and transition to permanent residential aged care (PRAC). DESIGN: Retrospective cohort study from the Historical Cohort of the Registry of Senior Australians. SETTING: Community. PARTICIPANTS: In total, 69,171 Individuals (aged 75+) receiving home care packages (HCPs) between 2011 and 2015. OUTCOME MEASURES: Mortality and transition to PRAC. RESULTS: The claims for a management plan with team care arrangement (TCA) within 3 months of the health assessment (i.e. CGA) was present in 5% and associated with 14% lower mortality (adjusted hazard ratio [aHR], 95%CI = 0.86, 0.80-0.93) compared to no claims, lower than that seen with partial CGA which was either health assessment claims only 7.0% (aHR, 95%CI = 0.93, 0.89-0.97) or management plan coupled with TCA claims only 9.0% (aHR, 95%CI = 0.91, 0.89-0.97). This pattern was seen in those frailer but not in those where the frailty index score was <0.21. Claims for management plans coupled with TCAs alone were associated with a 10% lower transition to PRAC (asHR, 95%CI = 0.90, 0.85-0.96) in those with FI score < 0.21 while this estimate was not significant in individuals with FI score ≥ 0.21. CONCLUSION: It appears the conduct of a combination of interventions considered to be components of the CGA by GPs was associated with a lower risk of mortality that no claims or partial conduct of CGA.
dc.description.statementofresponsibilityRenuka Visvanathan, Azmeraw T. Amare, Steve Wesselingh, Maria C. Inacio
dc.identifier.citationAge and Ageing, 2021; 50(4):1243-1251
dc.identifier.doi10.1093/ageing/afaa272
dc.identifier.issn0002-0729
dc.identifier.issn1468-2834
dc.identifier.orcidVisvanathan, R. [0000-0002-1303-9479]
dc.identifier.orcidAmare, A.T. [0000-0002-7940-0335]
dc.identifier.urihttp://hdl.handle.net/2440/130713
dc.language.isoen
dc.publisherOxford University Press (OUP)
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1102208
dc.rights© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
dc.source.urihttps://doi.org/10.1093/ageing/afaa272
dc.subjectGeneral practice
dc.subjectolder people
dc.subjectfrailty
dc.subjectaged care
dc.subjectmortality
dc.titleGeneral practitioner conduct of clinical services representing comprehensive geriatric assessment is associated with lower risk of mortality in older Australians receiving home care packages
dc.typeJournal article
pubs.publication-statusPublished

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