TY - JOUR
T1 - Variation in direct healthcare costs to the health system by residents living in long-term care facilities
T2 - a Registry of Senior Australians study
AU - Khadka, Jyoti
AU - Ratcliffe, Julie
AU - Caughey, Gillian
AU - Air, Tracy
AU - Wesselingh, Steve
AU - Corlis, Megan
AU - Evans, Keith
AU - Inacio, Maria
N1 - Publisher Copyright:
© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
PY - 2024/6/4
Y1 - 2024/6/4
N2 - Objective: This study aimed to examine the national variation in government-subsidised healthcare costs of residents in long-term care facilities (LTCFs) and costs differences by resident and facility characteristics. Methods: A retrospective population-based cohort study was conducted using linked national aged and healthcare data of older people (≥65 years) living in 2112 LTCFs in Australia. Individuals' pharmaceutical, out-of-hospital, hospitalisation and emergency presentations direct costs were aggregated from the linked healthcare data. Average annual healthcare costs per resident were estimated using generalised linear models, adjusting for covariates. Cost estimates were compared by resident dementia status and facility characteristics (location, ownership type and size). Results: Of the 75,142 residents examined, 70% (N = 52,142) were women and 53.4% (N = 40,137) were living with dementia. The average annual healthcare cost (all costs in $A) was $9233 (95% CI $9150-$9295) per resident, with hospitalisation accounting for 47.2% of the healthcare costs. Residents without dementia had higher healthcare costs ($11,097, 95% CI $10,995-$11,200) compared to those with dementia ($7561, 95% CI $7502-$7620). Residents living in for-profit LTCFs had higher adjusted average overall annual healthcare costs ($11,324, 95% CI $11,185-$11,463) compared to those living in not-for-profit ($11,017, 95% CI $10,895-$11,139) and government ($9731, 95% CI $9365-$10,099) facilities. Conclusions: The healthcare costs incurred by residents of LTCFs varied by presence of dementia and facility ownership. The variation in costs may be associated with residents' care needs, care models and difference in quality of care across LTCFs. As hospitalisation is the biggest driver of the healthcare costs, strategies to reduce preventable hospitalisations may reduce downstream cost burden to the health system.
AB - Objective: This study aimed to examine the national variation in government-subsidised healthcare costs of residents in long-term care facilities (LTCFs) and costs differences by resident and facility characteristics. Methods: A retrospective population-based cohort study was conducted using linked national aged and healthcare data of older people (≥65 years) living in 2112 LTCFs in Australia. Individuals' pharmaceutical, out-of-hospital, hospitalisation and emergency presentations direct costs were aggregated from the linked healthcare data. Average annual healthcare costs per resident were estimated using generalised linear models, adjusting for covariates. Cost estimates were compared by resident dementia status and facility characteristics (location, ownership type and size). Results: Of the 75,142 residents examined, 70% (N = 52,142) were women and 53.4% (N = 40,137) were living with dementia. The average annual healthcare cost (all costs in $A) was $9233 (95% CI $9150-$9295) per resident, with hospitalisation accounting for 47.2% of the healthcare costs. Residents without dementia had higher healthcare costs ($11,097, 95% CI $10,995-$11,200) compared to those with dementia ($7561, 95% CI $7502-$7620). Residents living in for-profit LTCFs had higher adjusted average overall annual healthcare costs ($11,324, 95% CI $11,185-$11,463) compared to those living in not-for-profit ($11,017, 95% CI $10,895-$11,139) and government ($9731, 95% CI $9365-$10,099) facilities. Conclusions: The healthcare costs incurred by residents of LTCFs varied by presence of dementia and facility ownership. The variation in costs may be associated with residents' care needs, care models and difference in quality of care across LTCFs. As hospitalisation is the biggest driver of the healthcare costs, strategies to reduce preventable hospitalisations may reduce downstream cost burden to the health system.
KW - aged care
KW - costs variation
KW - healthcare costs
KW - longterm care
KW - nursing homes
KW - observational research
KW - older adults
KW - residential aged care
UR - https://www.scopus.com/pages/publications/85206527692
U2 - 10.1071/AH24081
DO - 10.1071/AH24081
M3 - Article
AN - SCOPUS:85206527692
SN - 0156-5788
VL - 48
SP - 511
EP - 518
JO - Australian Health Review
JF - Australian Health Review
IS - 5
ER -