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Type: Journal article
Title: Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
Author: Cations, M.
Lang, C.
Ward, S.A.
Caughey, G.E.
Crotty, M.
Whitehead, C.
Ahern, S.
Maddison, J.
Inacio, M.C.
Citation: Scientific Reports, 2021; 11(1):10674-10674
Publisher: Springer Science and Business Media LLC
Issue Date: 2021
ISSN: 2045-2322
Statement of
Monica Cations, Catherine Lang, Stephanie A. Ward, Gillian E. Caughey, Maria Crotty, Craig Whitehead .. et al.
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.
Keywords: Humans
Retrospective Studies
Cross-Sectional Studies
Information Storage and Retrieval
Aged, 80 and over
Middle Aged
Delivery of Health Care
Quality of Health Care
Quality Indicators, Health Care
Public Health Surveillance
Rights: © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/.
DOI: 10.1038/s41598-021-89646-x
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Appears in Collections:Pharmacology publications

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