Aged care funding data accurately reports some residents’ health conditions including dementia but underreports or misses others such as osteoporosis and heart illnesses, a new study shows.
The Macquarie University study investigated the health conditions of 9,436 residents from 68 facilities in New South Wales and the Australian Capital Territory from 2014 to 2017 using three different data sources.
The study used an algorithm to analyse data from the three sources – aged care funding assessments, administered medications and clinical notes in the aged care home’s electronic health record system – to identify the prevalence of 60 health conditions across the sector.
Lead researcher Dr Magda Raban said they found that Australia doesn’t have an accurate picture of what health conditions are affecting people in residential aged care.
“We found that the funding instrument and the funding data, which is typically used to look at what conditions affect people, underreports how many people have those conditions for many of those conditions,” Dr Raban told Australian Ageing Agenda.
The study found the most prevalent conditions among residents are constipation (76 per cent), hypertension (62 per cent) arthritis (61 per cent), dementia (58 per cent) and depression (54 per cent).
“Using the typical data source … gives a fairly good estimate of who has dementia in aged care, but for other conditions like osteoporosis, heart conditions, cataracts and glaucoma, it really doesn’t capture that at all,” said Dr Raban, senior research fellow at the Australian Institute of Health Innovation at Macquarie University.
“It shows that if we just rely on looking at the funding instrument data, we’re not always going to have a full picture of conditions affecting residents,” she said.
Nor will there be a full picture of how conditions are being addressed.
The findings on constipation, for example, show the condition is not managed according to best practice in many cases.
“Constipation should really be managed through dietary fibre intake and adequate fluid intake as well as physical activity. But we’re finding in the data that most residents have that managed that through regular laxative use, which is not ideal,” she said.
Dr Raban said the research was really looking at how the data that is usually locked in aged care provider systems can be turned into meaningful information.
Aged care is data rich because providers collect a lot of data, but it is information poor, she said.
“That data isn’t able to be easily translated into useful and meaningful information, so that’s quite a big gap. If we can close that gap, it will be a big contribution to trying to reform aged care and improve services.”
She said aged care systems should be designed so providers can run reports at the click of a button and see what they can do to better address residents’ needs.
The study is published in Population Health Metrics.
Access the research Measuring the prevalence of 60 health conditions in older Australians in residential aged care with electronic health records: a retrospective dynamic cohort study here.
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It would be interesting to review the primary source/s of information about residents’ medical conditions that is captured in residential aged care files, particularly if admission is accompanied by a change of GP. My experience is an overreliance on information from family members, and of errors in aged care documentation.
In my opinion, clinical information within the aged care facility and the planning of care is poor. Most maintenance is reactive – admission to the acute sector. We all know there is a process for clinical care which is and should be orchestrated by General Practitioners. Why are Aged Care Facilities not part of an education/training program for all Medical Officers, Nurses and Allied Health Staff?