Article Synopsis |  | In Australia there has been a decline in the length of stay of older people in hospital as day-only procedures and early discharge policies has had an increasing effect. These changes have caused concern about the shifting costs from acute to community care services.
This 12 months study involved 2805 people aged 60 years and over who were living in Dubbo and examined data on use of services by these individuals following hospitalisation.
The findings revealed a low rate of use of Home and Community Care (HACC) services post-discharge, with only a quarter of older people receiving any type of HACC service in the 12 weeks after discharge, and two-thirds of these received only one service. Less than 5 per cent received a service from a occupational therapist, physiotherapist or speech therapist. 78 per cent older people, however, visited a general practitioner following discharge. These different rates of use are directly attributed to funding mechanisms as general practitioners are reimbursed from public funds. Further the predictors of higher cost services, like HACC and higher post-discharge service costs, were linked to a patient’s assessed need, especially lack of home supports.
The study concluded that service coordination and coordination of programs of care were relatively weak and advised that more attention be paid to: redefining the role of the hospital discharge planner and general practitioner in meeting the needs of older people; increasing the availability of HACC and related allied heath services and improving the linkage between the acute, primary age-care service systems. |