Acute Care Division (ACD)

Health Care of Older Australians Standing Committee (HCOASC)
- HCOASC research reports 2002 to 2004

One of the first activities of HCOASC (COAWG) was to undertake a research program which led to the release of 6 major reports.

One of the first activities of the Care of Older Australians Working Group (COAWG), predecessor to the HCOASC, was to undertake a research program which led to the release of 6 major reports.

• Mapping of Services at the Interfaces of Acute and Aged Care

• Service Provision for Older People in the Acute - Aged Care System

• Examination of Length of Stay for Older Persons in Acute Care and Sub-Acute Sectors

• Feasibility study on linking hospital morbidity and residential aged care data to examine the interface between the two sectors.

• Review of assessment & transition practices for older people in acute public hospitals

• Unnecessary and avoidable hospital admissions for older people

Mapping of Services at the Interfaces of Acute and Aged Care

This document is available on the Australian Health Ministers' Conference Publications page.

The research was undertaken by Applied Aged Care Solutions Pty Ltd with the report completed in 2002.

The report presents the findings of the Mapping Exercise undertaken as the first task in COAWG’s work program.

The task set out by the Working Group was:

• To undertake a stocktake of current care options and levels of provision in each State and Territory, including acute, sub-acute, step down and residential care models; and
• To use this information to identify models, which can be piloted as mechanisms for meeting system problems, and assess the influence of availability of alternative forms of care on patterns of service use.

Service Provision for Older People in the Acute - Aged Care System

This document is available on the Australian Health Ministers' Conference Publications page.

The research was undertaken by the National Ageing Research Institute and the Centre for Applied Gerontology with the report completed in 2002.

The study examined services that are relevant to the care of older people with acute illness, chronic illness and disability, and that operate in some way within hospitals or at the interface between hospitals and other care delivery systems.

Since these systems are administered by different levels of government, there was a need to develop a broader understanding of the overall "system" to inform policy, planning and program implementation at each level.

This project aimed to contribute to the essential knowledge base by investigating the availability of services for older people within and around the acute (hospital) care sub-system. This information was not readily available within existing information systems in a way that was comparable across jurisdictions.

Examination of Length of Stay for Older Persons in Acute Care and Sub-Acute Sectors

This document is available on the Australian Health Ministers' Conference Publications page.

The research was undertaken by Aged Care Evaluation & Management Advisors Pty Ltd with the report completed in 2003.

The project sought to determine the characteristics of older people (defined as aged 65 years or older for non-indigenous patients and 45 years or older for indigenous patients) with a potentially inappropriate admission/part of admission and/or potentially inappropriate length of stay. The brief for the project stated that the work should be carried out in three major components as follows:

• Desktop Analysis: an analysis of existing National Hospital Morbidity (Casemix) Database to identify older people who may have had a potentially inappropriate admission and/or length of stay. The purpose of the desktop analysis was also to identify and suggest changes to improve future data collected on admissions and length of stay.

• Hospital Survey: a prospective survey of all public hospitals in Australia to enumerate the broad dimensions of older people with a potentially inappropriate and/or extended length of stay. The survey identified the number of people in hospital who may be ready to leave hospital, but are waiting to receive a different type of care.

• Case Study Analysis: a number of case studies (29) to provide a comprehensive picture at the level of individual patients. These case studies were to answer a series of questions regarding the circumstances of individual patients and the issues arising from the care process.

This report addresses the broad dimensions and characteristics of older people with potentially inappropriate and/or extended length of stay by presenting a series of tables, figures and associated commentary from the desktop analysis and the hospital survey and by presenting a qualitative analysis of the information collected through the case study process.
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Feasibility study on linking hospital morbidity and residential aged care data to examine the interface between the two sectors.

This document is available on the Australian Health Ministers' Conference Publications page.

The research was conducted by the Australian Institute of Health and Welfare and released in 2002.

The interface between acute hospital care and residential aged care has long been recognised as an important issue in aged care services research.

In 2001 the Australian Institute of Health and Welfare (AIHW) independently commenced work on a project aimed at exploring statistically the interface between residential aged care services and the acute hospital sector using currently available data. The aim was to explore the feasibility of linking the national hospital morbidity and residential aged care collections and using the resulting linked data set to address key policy issues.

Late in 2001, the AIHW agreed that the feasibility study being undertaken within the Institute would proceed during 2002 under the auspices of COAWG. The report has been prepared as part of that agreement, and presents results of the tests which have been undertaken to explore the validity of the AIHW linkage strategy.

Review of assessment & transition practices for older people in acute public hospitals

Review of assessment & transition practices for older people in acute public hospitals - Final report (PDF 446 KB)

Appendices

• 1 Systematic Literature Review (PDF 1.4MB)
• 2A Articles identified in Systematic Literature Review, 2B Critical Appraisal Tools (PDF 2MB)
• 3A University Ethics Approval, 3B AHMAC Letter, 3C Information Forms (PDF 666 KB)
• 5A Continuity of Care Plan, 5B Needs Assessment (PDF 570 KB)
• 5C Patient and Nursing Risk Assessment, 5D Emergency Department Risk Assessments (PDF 1MB)
• 5G Mechanisms for sharing assessment information, 5H Examples of Systems Maps from each hospital bed strata, 6A Multidisciplinary Meeting Recording form, 6B Pre-Admission Assessments (PDF 1MB)
• 6C Emergency Department Assessment, 7A Reader Instrument, 7B Critical review form - Quantitative Studies (PDF 455 KB)
• 8A Comparison between field study findings and the literature (PDF 369 KB)

The research was undertaken by the Centre for Allied Health Research, Division of Health Sciences, University of South Australia with the report completed in 2003.

This project investigated the nature, structure and process of assessments taken in the public hospital setting to inform transition of elderly patients from the public hospital sector into the community.

The aims of the project were to:

• describe current hospital based assessment practices; and
• recommend standards for good assessment and transition practices to improve client outcomes.

Unnecessary and avoidable hospital admissions for older people

Unnecessary and avoidable hospital admissions for older people (PDF 822 KB)

The research was undertaken by Siggins Miller with the report completed in 2003.

Consumer demand for hospital services in Australia is increasing. Older people are significant users of hospital services, presenting at hospitals more often than other age groups and occupying a substantial proportion of beds. It has been argued that many admissions of older people are avoidable, and that the demands placed on the hospital system may be relieved if alternatives can be found.

The aim of this report was to provide the AHMAC Working Group on the Care of Older Australians with an evidence-base on unnecessary or avoidable admissions to complement its other projects, and to document successful interventions and alternative models of care on which policy and program responses can be built. It comprises a review of relevant research literature, interviews with nominated expert informants, a listing of current Australian initiatives, and conclusions and recommendations drawn from all these sources.


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