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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.
- Source :
- Age & Ageing; Jul2021, Vol. 50 Issue 4, p1243-1251, 9p, 1 Diagram, 2 Charts, 1 Graph
- Publication Year :
- 2021
-
Abstract
- Objectives 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- MORTALITY prevention
MORTALITY risk factors
CONFIDENCE intervals
FRAIL elderly
FAMILY medicine
MORTALITY
HOME care services
GERIATRIC assessment
MEDICAL care
RETROSPECTIVE studies
COMMUNITIES
MEDICAL care use
RISK assessment
ELIGIBILITY (Social aspects)
RESIDENTIAL care
DESCRIPTIVE statistics
MEDICARE
ELDER care
LONGITUDINAL method
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 50
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 151354046
- Full Text :
- https://doi.org/10.1093/ageing/afaa272