Utilisation of general practice health assessments around an aged care assessment is associated with lower mortality risk in older Australians

Renuka Visvanathan, Azmeraw T. Amare, Catherine Lang, Jyoti Khadka, Solomon Yu, Justin Beilby, Steve Wesselingh, Maria C. Inacio

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objective: (i) to describe the general practitioner utilisation of health assessments, management plans, coordination of team care arrangements and medication review item numbers within 6 months of an aged care eligibility assessment for home care packages (HCP) and (ii) investigate the impact of health assessments on the risk of mortality and entry into permanent residential aged care (PRAC) of individuals accessing HCP. Design and setting: Retrospective cohort study utilising data from the Registry of Senior Australians (ROSA) was conducted. Subjects: 75,172 individuals aged ≥75 years who received HCP between 2011 and 2015. Outcome measure: For objective 1: The use of comprehensive assessments (Medicare Benefits Schedule (MBS) items 705 or 707), management plans (MBS 721), coordination of team care arrangements (MBS 723), and medication reviews (MBS 900). For objective 2: Time to death and entry into PRAC. Results: Of the 75,172 individuals, 28.2% (95% confidence interval (CI): 27.8-8.5%) had comprehensive assessments, 36.7% (95% CI: 36.3-37.0%) had management plans, 33.0% (95% CI: 32.7-33.3%) received coordination of team care arrangements and 5.4% (95% CI: 5.2-5.5%) had medication reviews. Individuals with a comprehensive assessment had a 5% lower risk of mortality (adjusted hazard ratio (aHR), 95% CI = 0.95, 0.92-0.98) but 5% higher risk of transition to PRAC (adjusted subdistribution HRs, 95% CI = 1.05, 1.02-1.08) compared to those who did not have these services. Conclusion: The utilisation of health assessments was associated with a lower risk of mortality. There is an opportunity for increased use of item numbers in frailer individuals.

Original languageEnglish
Pages (from-to)120-126
Number of pages7
JournalAge and Ageing
Volume50
Issue number1
DOIs
Publication statusPublished - Jan 2021
Externally publishedYes

Keywords

  • aged care
  • frailty
  • general practice
  • health assessment
  • older people

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