People who wait six months or more for a home care package are more likely to die or go into residential care two years after getting the package than those who don’t spend as long in the queue, a study has found.
The study looked at almost 180,000 older people who got a home care package between 2003-2013. Of those, 74 per cent got a package within 6 months and 25 per cent after six months. A third received a package within a month.
Those who waited longer were more likely to be dead or in permanent care after two years.
The study, led by Professor Renuka Visvanathan of the University of Adelaide and published online in the Journal of Nutrition, Health and Aging on Thursday, found that people who waited more than six months for a home care package had an almost 20 per cent higher risk of dying compared to people who got a HCP within one month.
The risk of dying after moving into residential care two years after getting a HCP was also 10 per cent higher for people who had waited longer than six months.
The researchers suggest that the lack of timely access to care could contribute to increased frailty and deteriorating health.
“Prolonged wait times for HCP is associated with a higher risk of long-term mortality as well as transition to permanent residential aged care,” the study concludes.
Unmet needs can prove fatal
Professor Visvanathan told Community Care Review the results weren’t surprising.
“The main finding was that people who waited six months or more, when compared to those who waited less than 30 days, were more likely to die or enter a nursing home, but that effect was only seen after two years of receiving the package, so it was a delayed effect,” she said.
“Not getting your home care package means you have unmet needs, and not having your needs met couldn’t possibly be good for you.”
She said because the study stopped at 2013, the situation may be worse today with longer waiting times for a home care package.
As reported by Community Care Review, the latest Home Care Packages Program Data Report released at the end of November showed almost 127,000 people were waiting for a HCP that met their needs, with a wait of at least 12 months for all but the lowest level of support.
“The practical and policy implications of these findings is that we need to shorten the wait time. Thirty days may by unrealistic but perhaps as a start six months should be the maximum,” Professor Visvanathan said.
Link between wait times and death
The study used data from the Registry of Older South Australians to look at 178,924 older Australians who had been approved for a HCP and followed them for four years.
If found a link between wait times and risk of death even among those who waited less than six months.
Those who waited one to two months had a six per cent higher risk of dying and those who waited two to six months had a four per cent higher risk.
“The effect of wait time on risk of mortality was time -dependent, with longer wait times associated with higher mortality in the longer term,” the study found.
“The key findings from this research were that … when compared to those waiting less than 30 days for a HCP, those waiting more than six months had a higher risk for mortality and transition into permanent residential aged care services after two years.
“Additionally, for those who transitioned into permanent residential aged care services, mortality risk was higher for those waiting more than six months than those waiting less than 30 days and this was noticable after two years as well.
“By two years also, there was increased risk of transition to permanent residential aged care for those waiting 30 days or longer with the highest risk seen for those waiting more than six months.”
The study says it remains to be seen whether interventions to reduce the waiting time for HCPs, such as providing lower level packages or short-term interim services, would result in better survival and less reliance on residential care.
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