Showcasing our members: 16 November 2017.

This is part of a series of articles showcasing the Sax Institute members’ diverse range of research with implications for future health policy and practice.

Australian Institute of Health Innovation, Macquarie University

Dr Mikaela Jorgensen is mapping aged care journed

Dr Mikaela Jorgensen says the research is seeking to map the healthcare journey of older Australians.

With growing pressure on residential aged care services and a shift towards consumer-directed home care, researchers at the Australian Institute of Health Innovation (AIHI) are using data analytics to investigate the impact of reforms in aged care services on older adults’ outcomes.

Dr Mikaela Jorgensen, Research Fellow with the Centre for Health Systems and Safety Research at the AIHI, said the Centre was seeking to understand the journeys of older Australians to help inform policy makers, aged care service providers and older people themselves.

“There are nearly 1 million older people accessing community-based care services each year, and more than 90,000 on the waiting list for home care package services,” Dr Jorgensen said. “Although these services cost the government over $4 billion each year, there is very little large-scale research looking at people’s outcomes in community aged care.”

Dr Jorgensen said existing data on aged care was often “siloed”, with information available on a single aspect of the home care, residential care, or hospital sector. But, she said, analysing data routinely collected by service providers meant it was possible to piece together a more complete picture of a person’s trajectory from when they first begin accessing care services.

The Centre has teamed up with Uniting – a not-for-profit organisation and the largest provider of home and community care services in NSW and the ACT – to demonstrate how Uniting’s data systems can be used to better inform care delivery.

Monitoring the impact of aged care reforms

In a recent project, Dr Jorgensen and colleagues examined the impact of home-based services on time to entry into permanent residential aged care. They analysed data such as care needs, service provision, demographics, leave from service due to hospitalisation, and service cessation.

The researchers recently reported in the Journal of Post-Acute and Long-Term Care Medicine (JAMDA) that each additional hour of home-based service delivered was associated with a 6% lower risk of entry into residential care.

She said the findings were timely, coming after the introduction of consumer-directed care reforms to the Federal Government’s Home Care Package program from 2015.

“The aged care system is being overhauled, with moves to create a market-based system with more choice and control for consumers over their service delivery. But it’s important to monitor how these policy changes are impacting people’s outcomes; whether the policies are beneficial for everyone, or just for some people,” Dr Jorgensen said, adding that she was recently awarded a scholarship to further investigate the impact of consumer-directed care.

Looking at social engagement and quality of life

The study also found that the types of home care services people accessed influenced the time to entry into residential care. People who predominantly used social support services, alongside other support services, stayed at home longer than people who primarily used domestic support, personal care, or in-home respite.

“It’s an important finding that where people are supported to get out and about, and keep connected with their community, it can help them to stay at home for longer,” Dr Jorgensen said.

The Centre is also investigating routine quality of life assessment in home care. Dr Jorgensen said researchers were examining the benefits of embedding instruments to assess social engagement and quality of life – the Australian Community Participation Questionnaire (ACPQ) and the ICEpop CAPability Measure for Older Adults (ICECAP-O) – into standard assessment processes.

“This will help care providers to regularly start discussions with people about their quality of life and social engagement,” Dr Jorgensen said. “If we can gauge how older people are feeling about their psychosocial health, community care services can move beyond just meeting physical needs to help to enhance those areas as well.”

Data analytics is also being used to examine variations in medication use and the incidence of pressure injuries in residential aged care facilities.

“Providing feedback to aged care providers will help to improve services and inform other services about the importance of measuring and comparing these indicators,” Dr Jorgensen said.

The Sax Institute’s unique organisational structure, with 48 members from public health and health services research groups and their universities, connects us with a powerful public health network and world‑leading research expertise.

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