Primary, Allied Health, Selected Specialists, and Mental Health Service Utilisation by Home Care Recipients in Australia Before and After Accessing the Care, 2017-2019

Overview

Journal Aging Clin Exp Res

Publisher Springer

Specialty Geriatrics

Date 2024 Mar 29

PMID 38551712

Authors

Kailash Thapaliya

Gillian E Caughey

Maria Crotty

Helena Williams

Steve L Wesselingh

David Roder

Victoria Cornell

Gillian Harvey

Janet K Sluggett

Tiffany K Gill

Monica Cations

Jyoti Khadka

Andrew Kellie

Maria C Inacio

Affiliations

Soon will be listed here.

Abstract

Objectives: To examine changes in primary, allied health, selected specialists, and mental health service utilisation by older people in the year before and after accessing home care package (HCP) services.

Methods: A retrospective cohort study using the Registry of Senior Australians Historical National Cohort (≥ 65 years old), including individuals accessing HCP services between 2017 and 2019 (N = 109,558), was conducted. The utilisation of general practice (GP) attendances, health assessments, chronic disease management plans, allied health services, geriatric, pain, palliative, and mental health services, subsidised by the Australian Government Medicare Benefits Schedule, was assessed in the 12 months before and after HCP access, stratified by HCP level (1-2 vs. 3-4, i.e., lower vs. higher care needs). Relative changes in service utilisation 12 months before and after HCP access were estimated using adjusted risk ratios (aRR) from Generalised Estimating Equation Poisson models.

Results: Utilisation of health assessments (7-10.2%), chronic disease management plans (19.7-28.2%), and geriatric, pain, palliative, and mental health services (all ≤ 2.5%) remained low, before and after HCP access. Compared to 12 months prior to HCP access, 12 months after, GP after-hours attendances increased (HCP 1-2 from 6.95 to 7.5%, aRR = 1.07, 95% CI 1.03-1.11; HCP 3-4 from 7.76 to 9.32%, aRR = 1.20, 95%CI 1.13-1.28) and allied health services decreased (HCP 1-2 from 34.8 to 30.7%, aRR = 0.88, 95%CI 0.87-0.90; HCP levels 3-4 from 30.5 to 24.3%, aRR = 0.80, 95%CI 0.77-0.82).

Conclusions: Most MBS subsidised preventive, management and specialist services are underutilised by older people, both before and after HCP access and small changes are observed after they access HCP.

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