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Clustered domesticresidential aged carein Australia: fewerhospitalisations andbetter quality oflife Suzanne M DyerEnwu LiuEmmanuel S. Gnanamanickam2018 год

Clustered domestic residential aged care in Australia: fewer hospitalisations and better quality of life
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Аннотация: Objective: To compare the outcomes and costs of clustered domestic and standard Australian models of residential aged care. Design: Cross-sectional retrospective analysis of linked health service data, January 2015 – February 2016. Setting: 17 aged care facilities in four Australian states providing clustered (four) or standard Australian (13) models of residential aged care. Participants: People with or without cognitive impairment residing in a residential aged care facility (RACF) for at least 12 months, not in palliative care, with a family member willing to participate on their behalf if required. 901 residents were eligible; 541 consented to participation (24% self-consent, 76% proxy consent). Main outcome measures: Quality of life (measured with EQ-5D-5L); medical service use; health and residential care costs. Results: After adjusting for patient- and facility-level factors, individuals residing in clustered models of care had better quality of life (adjusted mean EQ-5D-5L score difference, 0.107; 95% CI, 0.028–0.186; P = 0.008), lower hospitalisation rates (adjusted rate ratio, 0.32; 95% CI, 0.13–0.79; P = 0.010), and lower emergency department presentation rates (adjusted rate ratio, 0.27; 95% CI, 0.14–0.53; P < 0.001) than residents of standard care facilities. Unadjusted facility running costs were similar for the two models, but, after adjusting for resident- and facility-related factors, it was estimated that overall there is a saving of $12 962 (2016 values; 95% CI, $11 092–14 831) per person per year in residential care costs. Conclusions: Clustered domestic models of residential care are associated with better quality of life and fewer hospitalisations for residents, without increasing whole of system costs.
Год издания: 2018
Авторы: Suzanne M Dyer, Enwu Liu, Emmanuel S. Gnanamanickam, Rachel Milte, Tiffany Easton, Stephanie L. Harrison, Clare Bradley, Julie Ratcliffe, Maria Crotty
Издательство: Wiley
Источник: The Medical Journal of Australia
Ключевые слова: Geriatric Care and Nursing Homes, Palliative Care and End-of-Life Issues, Frailty in Older Adults