Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users

Abstract Care quality has important implications for people with dementia. We examined trends and geographical variation of four clinical quality indicators (CQIs) in Australia. This retrospective cohort study included all people with dementia using Australian government-subsidised aged care in 2008...

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Autores principales:	Monica Cations, Catherine Lang, Stephanie A. Ward, Gillian E. Caughey, Maria Crotty, Craig Whitehead, Susannah Ahern, John Maddison, Maria C. Inacio
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/92d0d5de8883421aa1106d3cd543ecec
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spelling	oai:doaj.org-article:92d0d5de8883421aa1106d3cd543ecec2021-12-02T14:59:15ZUsing data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users10.1038/s41598-021-89646-x2045-2322https://doaj.org/article/92d0d5de8883421aa1106d3cd543ecec2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89646-xhttps://doaj.org/toc/2045-2322Abstract Care quality has important implications for people with dementia. We examined trends and geographical variation of four clinical quality indicators (CQIs) in Australia. This retrospective cohort study included all people with dementia using Australian government-subsidised aged care in 2008–2016 (n = 373,695). Quality indicator data were derived from linked national aged care, health, and pharmaceutical datasets. Negative binomial regression modelling assessed trends in CQI performance over time (2011–2016) and funnel plots examined geographical variation in performance. The incidence rate of antipsychotic medicine dispensing decreased slightly from 1.17/1000 person-days to 1.07/1000 person-days (adjusted incidence rate ratio (aIRR) = 0.98, 95%CI 0.98–0.99). Cholinesterase inhibitors and memantine dispensing did not change (aIRR = 1.02, 95%CI 1.00–1.04), while exposure to high sedative load increased slightly from 1.39/1000 person-days to 1.44/1000 person-days (aIRR = 1.01, 95%CI 1.00–1.01). Dementia and delirium-related hospitalisations increased slightly from 0.17/1000 person-days to 0.18/1000 person-days (aIRR = 1.02, 95%CI 1.01–1.03). There was marked variation in cholinesterase inhibitor and memantine dispensing by geographical area (0–41%). There has been little change in four indicators of dementia care quality in Australian aged care users over time. Cholinesterase inhibitor and memantine dispensing varied substantially by geographical region. Existing strategies to improve national performance on these indicators appear to be insufficient, despite the significant impact of these indicators on outcomes for people with dementia.Monica CationsCatherine LangStephanie A. WardGillian E. CaugheyMaria CrottyCraig WhiteheadSusannah AhernJohn MaddisonMaria C. InacioNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Monica Cations Catherine Lang Stephanie A. Ward Gillian E. Caughey Maria Crotty Craig Whitehead Susannah Ahern John Maddison Maria C. Inacio Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
description	Abstract Care quality has important implications for people with dementia. We examined trends and geographical variation of four clinical quality indicators (CQIs) in Australia. This retrospective cohort study included all people with dementia using Australian government-subsidised aged care in 2008–2016 (n = 373,695). Quality indicator data were derived from linked national aged care, health, and pharmaceutical datasets. Negative binomial regression modelling assessed trends in CQI performance over time (2011–2016) and funnel plots examined geographical variation in performance. The incidence rate of antipsychotic medicine dispensing decreased slightly from 1.17/1000 person-days to 1.07/1000 person-days (adjusted incidence rate ratio (aIRR) = 0.98, 95%CI 0.98–0.99). Cholinesterase inhibitors and memantine dispensing did not change (aIRR = 1.02, 95%CI 1.00–1.04), while exposure to high sedative load increased slightly from 1.39/1000 person-days to 1.44/1000 person-days (aIRR = 1.01, 95%CI 1.00–1.01). Dementia and delirium-related hospitalisations increased slightly from 0.17/1000 person-days to 0.18/1000 person-days (aIRR = 1.02, 95%CI 1.01–1.03). There was marked variation in cholinesterase inhibitor and memantine dispensing by geographical area (0–41%). There has been little change in four indicators of dementia care quality in Australian aged care users over time. Cholinesterase inhibitor and memantine dispensing varied substantially by geographical region. Existing strategies to improve national performance on these indicators appear to be insufficient, despite the significant impact of these indicators on outcomes for people with dementia.
format	article
author	Monica Cations Catherine Lang Stephanie A. Ward Gillian E. Caughey Maria Crotty Craig Whitehead Susannah Ahern John Maddison Maria C. Inacio
author_facet	Monica Cations Catherine Lang Stephanie A. Ward Gillian E. Caughey Maria Crotty Craig Whitehead Susannah Ahern John Maddison Maria C. Inacio
author_sort	Monica Cations
title	Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
title_short	Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
title_full	Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
title_fullStr	Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
title_full_unstemmed	Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
title_sort	using data linkage for national surveillance of clinical quality indicators for dementia care among australian aged care users
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/92d0d5de8883421aa1106d3cd543ecec
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Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users

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