An exploration of healthcare use in older people waiting for and receiving Australian community‐based aged care services

Author:

Edney Laura C.1ORCID,Haji Ali Afzali Hossein1ORCID,Visvanathan Renuka23ORCID,Toson Barbara4ORCID,Karnon Jonathan1ORCID

Affiliation:

1. Flinders Health and Medical Research Institute Flinders University Adelaide South Australia Australia

2. Aged and Extended Care Services Queen Elizabeth Hospital and Basil Hetzel Institute, Central Adelaide Local Health Network Adelaide South Australia Australia

3. Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre Adelaide Medical School, University of Adelaide Adelaide South Australia Australia

4. College of Medicine and Public Health Flinders University Adelaide South Australia Australia

Abstract

AimHome care packages (HCPs) facilitate older individuals to remain at home, with longer HCP wait times associated with increased mortality risk. We analyze healthcare cost data pre‐ and post‐HCP access to inform hypotheses around the effects of healthcare use and mortality risk.MethodsRegression models were used to assess the impact of delayed HCP access on healthcare costs and to compare costs whilst waiting and in the 6‐ and 12 month periods post‐HCP access for 16 629 older adults.ResultsAverage wait time for a HCP was 89.7 days (SD = 125.6) during the study period. Wait‐time length had no impact on any healthcare cost category or time period. However, total per day healthcare costs were higher in the 6 and 12 months post‐receipt of a HCP (AU$61.5, AU$63, respectively) compared with those in the time waiting for a HCP (AU$48.1). Inpatient care accounted for a higher proportion of total healthcare costs post‐HCP (AU$45.1, AU$46.3, respectively) compared with in the wait time (AU$30.6), whilst spending on medical services and pharmaceuticals reduced slightly in the 6 month (AU$7.1, AU$6.3) and 12 month (AU$7.2, AU$6.3) post‐HCP periods compared with in the wait time (AU$7.9, AU$7.1).ConclusionsIncreased spending post‐HCP on inpatient care or non‐health support afforded by HCPs may offer protective effects for mortality and risk of admission to aged care. Further research should explore the association between delayed access to inpatient care for geriatric syndromes and mortality to inform recommendations on extensions to residential care outreach services into the community to improve the timely identification of the need for inpatient care. Geriatr Gerontol Int 2023; 23: 899–905.

Publisher

Wiley

Subject

General Medicine

Reference28 articles.

1. Australian Institute of Health and Welfare.Older Australians. AIHW Australian Government Available from:https://www.aihw.gov.au/reports/older-people/older-australians/contents/about2021.

2. Department of Health and Aged Care Australian Government.About the Home Care Packages Program 2023. Available from:https://www.health.gov.au/our-work/home-care-packages-program/about.

3. My Aged Care.Australian Government Available from:https://www.myagedcare.gov.au/help-at-home/home-care-packages/what-services-can-i-receive.

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