MRFF - Primary Health Care Research
“Using big data to create evidence-based primary health care service delivery and policy for the Australian aged care sector - a nationwide study”
This project employs ROSA to produce the high-quality evidence necessary for practice and policy recommendations related to access, variation, effectiveness, and costs associated with providing primary health care services that improve the health and wellbeing of aged care recipients, either living in residential aged care facilities or the community.
We recognise that data driven policy and practice recommendations, informed by key-stakeholder consultation and supported by high quality medical informatics, as included in this project, are needed to inform and empower primary care about best value-added care that can be provided to aged care recipients.
Why is this study important?
Figure 1 from grant proposal: Project Aims, Policy Collaborative, and Stakeholders.
Primary health care practitioners are uniquely positioned to coordinate and integrate the complex demands of individuals in aged care. However, primary health care in Australia is overburdened and criticised in some instances as ineffective and disconnected. Individuals in the aged care sector are particularly vulnerable to the challenges affecting the primary care sector. Complex multimorbidity and frailty profiles, which lead to high rates of polypharmacy, often complicated by significant functional and cognitive impairment are common in the 1.5 million older people accessing aged care services each year. Not surprisingly, these individuals are heavily reliant on the multidisciplinary range of primary health care professionals for advice, treatment, and health management, with 96-98% visiting a general practitioner (GP) on average 16-25 times a year.
However, the extent of which primary care services are accessed, or vary in provision, and ultimately affect outcomes of particular interest to individuals in aged care is unknown at the population level. As highlighted in the 2018 Australian Medical Association’s Position Statement, an evaluation of the access and effectiveness of primary care services in the care of older people to ensure their needs are met has not been conducted nationally and is needed. A key reason for lack of evidence in this area is because the infrastructure required to undertake this task has only recently been established with the development of ROSA.
Project team:
CHIEF INVESTIGATORS
Prof Maria Inacio, ROSA Director, SAHMRI.
Prof Maria Crotty, Flinders University.
Dr Helena Williams, Silver Chain Group.
Prof Gillian Caughey, ROSA Associate Director, SAHMRI.
Prof Gillian Harvey, University of Adelaide.
Prof Steve Wesselingh, SAHMRI.
Prof David Roder, UniSA.
Dr Jyoti Khadka, ROSA, SAHMRI.
Dr Tiffany Gill, University of Adelaide.
Dr Janet Sluggett, UniSA/ROSA.
ASSOCIATE INVESTIGATORS
Dr Adrienne Lewis, Oral Health in Aged Care Expert, SA Dental Service.
Dr Andrew Kellie, General Practitioner and Medical Director, The Healthy Collective.
A/Prof Craig Whitehead, Geriatrician and Director, Flinders Medical Centre Division of Rehab, Aged Care & Palliative Care.
Mrs Marilyn Von Thien, Consumer Representative and Member of ROSA Consumer & Community Committee.
Ms Megan Corlis, Director, Education Research & Aged Care, Australian Nursing and Midwifery Federation (SA Branch)
Dr Monica Cations, Early Career Postdoctoral Researcher and Provisional Psychologist, SAHMRI and Flinders University.
Dr Victoria Cornell, Researcher, ECH Inc, and Board Member, Australian Association of Gerontology.
Additional ROSA Research Team Members involved in this project:
Dr Kailash Thapaliya, ROSA Research Fellow
Ms Tracy Air, ROSA Statistician
Dr Johannes Schwabe, ROSA Statistician
Project outputs:
Publications to date
Thapaliya K, Caughey G, Crotty M, Williams H, Wesselingh S, Roder D, Cornell V, Harvey G, Sluggett J, Gill T, Cations M, Khadka J, Kellie A, Inacio M. Primary, Allied Health, Selected Specialists, and Mental Health Service Utilisation by Home Care Recipients in Australia Before and After Accessing the Care. Ageing Clinical and Experimental Research. March 2024; 36:83.
Caughey G, Rahja M, Collier L, Air T, Thapaliya K, Crotty M, Williams H, Harvey G, Sluggett JK, Gill TK, Khadka J, Roder D, Kellie AR, Wesselingh S, Inacio MC on behalf of the ROSA Primary Care Research Collaborator. Primary health care service utilisation before and after entry into long-term care in Australia. Archives of Gerontology and Geriatrics. February 2024; 117:105210.
Caughey G, Collier L, Cations M, Wesselingh S, Inacio M. Evaluation of uptake of COVID-19 temporary MBS-allied health services for residential aged care. Journal of the American Medical Directors Association, 2023 1-4. https://doi.org/10.1016/j.jamda.2023.02.019
Inacio MC, Collier L, Air T, Thapaliya K, Crotty M, Williams H, Wesselingh SL, Kellie A, Roder D, Lewis A, Harvey G, Sluggett JK, Cations M, Gill T, Khadka J, Caughey GE. Primary, allied health, geriatric, pain and palliative healthcare service utilisation by aged care residents, 2012-2017. Australasian journal on ageing. 2023 10.1111/ajag.13199. https://doi.org/10.1111/ajag.13199
Bartholomaeus JD, Collier LR, Lang C, Cations M, Kellie AR, Inacio MC, Caughey GE. Trends in mental health service utilisation by Australia's older population. Australasian Journal on Ageing. 2022 https://doi.org/10.1111/ajag.13118
Cations M, Collier LR, Caughey G, Bartholomaeus J, Lang C, Crotty M, Harvey G, Wesselingh S, Corlis M, Inacio MC. Government-subsidised mental health services are underused in Australian residential aged care facilities. Australian Health Review. 2022 46(4), 432-441. https://doi.org/10.1071/AH22049
Dyer S, Suen J, Williams H, Inacio MC, Harvey G, Roder D, Wesselingh S, Kellie A, Crotty M, Caughey GE. Impact of relational continuity of primary care in aged care: a systematic review. BMC Geriatrics. 2022 In Press. https://doi.org/10.1186/s12877-022-03131-2
Khadka J, Ratcliffe J, Caughey GE, Wesselingh SL, Inacio MC. Prevalence of eye conditions, utilization of eye health care services and ophthalmic medications after entering residential aged care in Australia. Translational Vision Science and Technology. December 2021; 10(14):3.
Sluggett J, Dinh Y, Wesselingh S, Inacio M, Caughey G. National Changes in Outpatients Systemic Antibiotic Use During the Coronavirus Disease 2019 (COVID-19) Pandemic in Australia. Clinical Infectious Diseases. December 2021; 73(11):2150-2152.
Sluggett JK, Collier L, Bartholomaeus JD, Inacio MC, Wesselingh SL, Caughey GE. National Trends and Policy Impacts on Provision of Home Medicines Reviews and Residential Medication Management Reviews in Older Australians, 2009-2019. International Journal of Environmental Research and Public Health. September 2021; 18(18):9898.
Bartholomaeus JD, Inacio MC, Williams H, Wesselingh SL, Caughey GE. Primary Health Care Utilisation by Older Australians During the COVID-19 Pandemic. Internal Medicine Journal. May 2021; 51(5):818-820.
Primary Health Care Policy Collaborative
The Primary Health Care Policy Collaborative was established in 2021 to bring together aged care providers, primary care providers, consumers, clinicians, peak bodies, and researchers to ensure strategies aimed at optimising the opportunities for pragmatic translation of the project’s findings into tangible and realistic actions are embedded into the project.
Workshops
Primary Health Care Policy Collaborative Workshop – April 1st 2022
The first Workshop attracted 53 participants and assisted the project team with:
Identification of key and timely research priorities
Review and facilitate interpretation of analytical findings
Inform policy/practice recommendations arising from our research
Formulate strategies to influence primary care service policy in the aged care context.
Images: Participants at the Policy Collaborative Workshop – April 1st 2022.
The second Primary Health Care Policy Collaborative Workshop – March 10th 2023
This second Workshop attracted 50 participants and the attendees:
Discussed project updates since last workshop
Discussed how to disseminate and implement project findings
Discussed new priorities based on the key findings to date
Identified next steps for the research team.
Image: Participants at the Policy Collaborative Workshop – March 10th 2023
Contact:
For more information email Prof Gillian Caughey (email: Gillian.Caughey@sahmri.com).