A nation-wide evaluation of older people's use of primary health care and its effectiveness in people living in aged care is being done.
The Registry of Senior Australians, started in 2017, includes health care and aged care data from around Australia. When combined, the data gives a picture of Australia's ageing pathways.
Professor Maria Inacio is the registry's director at the South Australian Health and Medical Research Institute. She is leading the evaluation of older people's use of primary health care and the effectiveness of this care in aged care settings, through using these combined data sets.
Professor Inacio said 93 per cent of people in aged care sites visit a GP about 25 times a year, but the results of these visits or if they meet older people's needs are unknown.
To answer that question, Professor Inacio is examining the relationship of primary health care services with:
"I want to be able to find the services or best combination of services that an older person can get to do the best they can. So, it's better for them, better for the system and less expensive," she said.
So far, Professor Inacio has found there are three health care 'pathways' for older people in aged care sites, which have different mortality results.
She found people who had preventive or multidisciplinary health care had the lowest mortality. This may have been through health assessments, chronic disease management plans or multidisciplinary care plans, medication reviews and accessing allied health services.
Those who saw a GP a few times a year and had few other services had mid-level mortality. Professor Inacio said this was likely due to them having less health issues.
But those who saw a GP often, including urgent, after-hours consultations, had the highest mortality. Professor Inacio said this may be because they had declining health, but also because their health care is not well managed.
"It is reassuring to know that preventive health care can have a positive impact. We need to give people in aged care the best quality of life and the best experience they can have," she said.
But the study showed older people don't get as much preventative healthcare as they should. Professor Inacio said people should have chronic disease management plans and a health assessment and medication review every year. Also, they should get more mental health and allied health services.
"This may be enough to keep older people healthy with a stable level of functional capacity and prevent cognitive decline," she said.
"But only about half of the people who are eligible for chronic disease management plans get them. The use of other services is even lower. This doesn't change much or gets worse once they enter aged care settings, which is unfortunate."
The research showed more coordinated and comprehensive primary health care could improve the health of older people. This could translate into lower risk of hospitalisations and other health events, and could make cost savings.
Professor Inacio is working with people who deliver primary health care to older people in aged care settings to help guide the research. The research received a $1.435 million grant from the Medical Research Future Fund , which also granted the registry $2 million in 2021.
While this study is new, data collected by the registry has been already used elsewhere; Professor Inacio used the registry's data to give evidence to the Royal Commission into Aged Care Quality and Safety.
"Our data influenced the Royal Commission's recommendations. It helped drive reforms to aged care,' she said.
"For example, our data showed that when older people entered aged care facilities they received more psychotropic drugs. That evidence supported a recommendation to reduce the use of psychotropic drugs in aged care facilities.
"Since the Royal Commission, there has been better quality and safety monitoring and a better data strategy to evaluate aged care quality."
Click here for more information about the registry.
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