TY - JOUR
T1 - Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses
AU - Caughey, Gillian Elizabeth
AU - Lang, Catherine E
AU - Bray, Sarah Catherine Elizabeth
AU - Sluggett, Janet K
AU - Whitehead, Craig
AU - Visvanathan, Renuka
AU - Evans, Keith
AU - Corlis, Megan
AU - Cornell, Victoria
AU - Barker, Anna L
AU - Wesselingh, Steve
AU - Inacio, Maria C
PY - 2022/8
Y1 - 2022/8
N2 - Objectives To develop and examine the prevalence of quality and safety indicators to monitor care of older Australians receiving home care packages (HCPs), a government-funded aged care programme to support individuals to live at home independently. Design Cross-sectional. Setting Home care recipients, Australia. Participants 90 650 older individuals (aged ≥65 years old and ≥50 years old for people of Aboriginal or Torres Strait Islander descent) who received a HCP between 1 January 2016 and 31 December 2016 nationally were included. Primary and secondary outcome measures The Registry of Senior Australians developed 15 quality and safety indicators: antipsychotic use, high sedative load, chronic opioid use, antimicrobial use, premature mortality, home medicines reviews, chronic disease management plan, wait-time for HCP, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium/ dementia-related hospitalisations, emergency department (ED) presentations and pressure injuries. Risk adjusted prevalence (%, 95% CI) and geographical area (statistical level 3) variation during 2016 were examined. Results In 2016, a total of 102 590 HCP episodes were included for 90 650 individuals, with 66.9% (n=68 598) level 1-2 HCP episodes (ie, for basic care needs) and 33.1% (n=33 992) level 3-4 HCP (ie, higher care needs). The most prevalent indicators included: antibiotic use (52.4%, 95% CI 52.0 to 52.7), chronic disease management plans (38.1%, 95% CI 37.8 to 38.4), high sedative load (29.1%, 95% CI 28.8 to 29.4) and ED presentations (26.4%, 95% CI 25.9 to 26.9). HCP median wait time was 134 days (IQR 41-406). Geographical variation was highest in chronic disease management plans and ED presentations (20.7% of areas outside expected range). Conclusion A comprehensive outcome monitoring system to monitor the quality and safety of care and variation for HCP recipients was developed. It provides a pragmatic, efficient and low burden tool to support evidence-based quality and safety improvement initiatives for the aged care sector.
AB - Objectives To develop and examine the prevalence of quality and safety indicators to monitor care of older Australians receiving home care packages (HCPs), a government-funded aged care programme to support individuals to live at home independently. Design Cross-sectional. Setting Home care recipients, Australia. Participants 90 650 older individuals (aged ≥65 years old and ≥50 years old for people of Aboriginal or Torres Strait Islander descent) who received a HCP between 1 January 2016 and 31 December 2016 nationally were included. Primary and secondary outcome measures The Registry of Senior Australians developed 15 quality and safety indicators: antipsychotic use, high sedative load, chronic opioid use, antimicrobial use, premature mortality, home medicines reviews, chronic disease management plan, wait-time for HCP, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium/ dementia-related hospitalisations, emergency department (ED) presentations and pressure injuries. Risk adjusted prevalence (%, 95% CI) and geographical area (statistical level 3) variation during 2016 were examined. Results In 2016, a total of 102 590 HCP episodes were included for 90 650 individuals, with 66.9% (n=68 598) level 1-2 HCP episodes (ie, for basic care needs) and 33.1% (n=33 992) level 3-4 HCP (ie, higher care needs). The most prevalent indicators included: antibiotic use (52.4%, 95% CI 52.0 to 52.7), chronic disease management plans (38.1%, 95% CI 37.8 to 38.4), high sedative load (29.1%, 95% CI 28.8 to 29.4) and ED presentations (26.4%, 95% CI 25.9 to 26.9). HCP median wait time was 134 days (IQR 41-406). Geographical variation was highest in chronic disease management plans and ED presentations (20.7% of areas outside expected range). Conclusion A comprehensive outcome monitoring system to monitor the quality and safety of care and variation for HCP recipients was developed. It provides a pragmatic, efficient and low burden tool to support evidence-based quality and safety improvement initiatives for the aged care sector.
UR - https://www.mendeley.com/catalogue/449dc959-ca72-3211-9dae-9c18527e4cc8/
U2 - 10.1136/bmjopen-2022-063152
DO - 10.1136/bmjopen-2022-063152
M3 - Article
SN - 2044-6055
VL - 12
SP - e063152
JO - BMJ open
JF - BMJ open
IS - 8
ER -