Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/136372
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Type: | Journal article |
Title: | Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses |
Author: | Caughey, G.E. Lang, C.E. Bray, S.C.E. Sluggett, J.K. Whitehead, C. Visvanathan, R. Evans, K. Corlis, M. Cornell, V. Barker, A.L. Wesselingh, S. Inacio, M.C. |
Citation: | BMJ Open, 2022; 12(8):e063152-1-e063152- 11 |
Publisher: | BMJ Journals |
Issue Date: | 2022 |
ISSN: | 2044-6055 2044-6055 |
Statement of Responsibility: | Gillian Elizabeth Caughey, Catherine E Lang, Sarah Catherine Elizabeth Bray, Janet K Sluggett, Craig Whitehead, Renuka Visvanathan, Keith Evans, Megan Corlis, Victoria Cornell, Anna L Barker, Steve Wesselingh, Maria C Inacio |
Abstract: | 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. |
Rights: | © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
DOI: | 10.1136/bmjopen-2022-063152 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/APP1156439 |
Published version: | http://dx.doi.org/10.1136/bmjopen-2022-063152 |
Appears in Collections: | Medicine publications |
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hdl_136372.pdf | Published version | 612 kB | Adobe PDF | View/Open |
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