Use of medical services by older Australian women with dementia: a longitudinal cohort study
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 diagn...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | Australian and New Zealand Journal of Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1753-6405.13146 |
| _version_ | 1797712792243929088 |
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| author | Julie Byles Dominic Cavenagh Jamie Bryant Danielle Mazza Colette Browning Sally O'Loughlin Rob Sanson‐Fisher |
| author_facet | Julie Byles Dominic Cavenagh Jamie Bryant Danielle Mazza Colette Browning Sally O'Loughlin Rob Sanson‐Fisher |
| author_sort | Julie Byles |
| collection | DOAJ |
| description | 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). |
| first_indexed | 2024-03-12T07:27:01Z |
| format | Article |
| id | doaj.art-3ae41ceb41ff46ba90f8d56a0c143e3e |
| institution | Directory Open Access Journal |
| issn | 1326-0200 1753-6405 |
| language | English |
| last_indexed | 2024-03-12T07:27:01Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Australian and New Zealand Journal of Public Health |
| spelling | doaj.art-3ae41ceb41ff46ba90f8d56a0c143e3e2023-09-02T22:05:38ZengElsevierAustralian and New Zealand Journal of Public Health1326-02001753-64052021-10-0145549750310.1111/1753-6405.13146Use of medical services by older Australian women with dementia: a longitudinal cohort studyJulie Byles0Dominic Cavenagh1Jamie Bryant2Danielle Mazza3Colette Browning4Sally O'Loughlin5Rob Sanson‐Fisher6Centre for Women's Health Research The University of Newcastle New South WalesCentre for Women's Health Research The University of Newcastle New South WalesHealth Behaviour Research Group The University of Newcastle New South WalesDepartment of General Practice Monash University VictoriaSchool of Health Federation University VictoriaService Specialist Excellence, Uniting New South WalesHealth Behaviour Research Group The University of Newcastle New South WalesAbstract 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).https://doi.org/10.1111/1753-6405.13146health service usedementiageneral practicehealth assessmentslongitudinal study |
| spellingShingle | Julie Byles Dominic Cavenagh Jamie Bryant Danielle Mazza Colette Browning Sally O'Loughlin Rob Sanson‐Fisher Use of medical services by older Australian women with dementia: a longitudinal cohort study Australian and New Zealand Journal of Public Health health service use dementia general practice health assessments longitudinal study |
| title | Use of medical services by older Australian women with dementia: a longitudinal cohort study |
| title_full | Use of medical services by older Australian women with dementia: a longitudinal cohort study |
| title_fullStr | Use of medical services by older Australian women with dementia: a longitudinal cohort study |
| title_full_unstemmed | Use of medical services by older Australian women with dementia: a longitudinal cohort study |
| title_short | Use of medical services by older Australian women with dementia: a longitudinal cohort study |
| title_sort | use of medical services by older australian women with dementia a longitudinal cohort study |
| topic | health service use dementia general practice health assessments longitudinal study |
| url | https://doi.org/10.1111/1753-6405.13146 |
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