Use of medical services by older Australian women with dementia : a longitudinal cohort study

- Byles, Julie, Cavenagh, Dominica, Bryant, Jamie, Mazza, Danielle, Browning, Colette, O'Loughlin,Sally

Title
Use of medical services by older Australian women with dementia : a longitudinal cohort study
Creator
Byles, Julie; Cavenagh, Dominica; Bryant, Jamie; Mazza, Danielle; Browning, Colette; O'Loughlin,Sally
Date
2021
Type
Text; Journal article
Identifier
http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/179007
Identifier
vital:15493
Identifier
https://doi.org/10.1111/1753-6405.13146
Identifier
ISBN:1326-0200 (ISSN)
Abstract
Objective: To assess the use of Medicare-subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non-emergency GP attendances (short [<30 minutes] IRR=1.11 [1.07, 1.13]; long [>30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs). © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Colette Browning” is provided in this record**
Contributor
Sanson-Fisher, Rob
Publisher
John Wiley and Sons Inc
Relation
Australian and New Zealand Journal of Public Health Vol. 45, no. 5 (2021), p. 497-503
Rights
All metadata describing materials held in, or linked to, the repository is freely available under a CC0 licence
Rights
https://creativecommons.org/licenses/by-nc-nd/4.0/
Rights
Copyright @ 2021 The Authors
Rights
Open Access
Subject
1117 Public Health and Health Services; 1402 Applied Economics; 1605 Policy and Administration; Dementia; General practice; Health assessments; Health service use; Longitudinal study
Full Text
Reviewed
Funder
The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women's Health by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data. The authors wish to acknowledge: the Department of Health, Veterans? Affairs, and Medicare Australia for providing MBS, PBS and Aged Care data and the Australian Institute of Health and Welfare (AIHW) as the integrating authority; Centre for Health Record Linkage (CHeReL), NSW Ministry of Health and ACT Health for the NSW Admitted patients and the ACT Admitted Patient Care Data Collections; Queensland Health, including the Statistical Services Branch, for the QLD Hospital Admitted Patient Data Collection; Department of Health Western Australia, including the Data Linkage Branch and the WA Hospital Morbidity Data Collection; SA NT Datalink and SA Health, for the SA Public Hospital Separations Data Collections; the assistance of the Data Linkage Unit at the Australian Institute of Health and Welfare (AIHW) for undertaking the data linkage to the National Death Index (NDI). This work was supported by a National Health and Medical Research Council Dementia Research Team Grant (APP1095078">https://pubmed.ncbi.nlm.nih.gov/?term=APP1095078%2FNational+Health+and+Medical+Research+Council%5BGrant+Number%5D">APP1095078). This research was also supported by infrastructure funding from the Hunter Medical Research Institute. The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women's Health by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data. Jamie Bryant is supported by an NHMRC-ARC Dementia Research Development Fellowship. Funding text 3: Jamie Bryant is supported by an NHMRC‐ARC Dementia Research Development Fellowship. Funding text 4: This work was supported by a National Health and Medical Research Council Dementia Research Team Grant ( APP1095078">https://pubmed.ncbi.nlm.nih.gov/?term=APP1095078%2FNational+Health+and+Medical+Research+Council%5BGrant+Number%5D">APP1095078 ). This research was also supported by infrastructure funding from the Hunter Medical Research Institute.
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