Beyond multimorbidity: primary care and the older person with complex needs

Mann, Jennifer, Thompson, Fintan, Quigley, Rachel, McDermott, Robyn, Devine, Sue, and Strivens, Edward (2021) Beyond multimorbidity: primary care and the older person with complex needs. Australian Journal of Primary Health, 27 (3). pp. 194-201.

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Abstract

The aim of this study was to present the health and social characteristics of community-dwelling older people within the Cairns region who were identified by their GP as having complex care needs. This paper reports the subanalysis of baseline data from the Older Persons Enablement and Rehabilitation (OPEN ARCH) stepped wedge randomised controlled trial of an integrated model of care for community-dwelling older people. Data were analysed at the level of the participant and the level of the participant cluster (group of participants from the one GP). Median quality of life, as assessed by the EQ-5D, was higher for females than males (80 vs 70 respectively; P = 0.05) and for people living alone than living with family (80 vs 60 respectively; P = 0.0940). There was greater functional independence among non-Indigenous than Indigenous participants (median Functional Independence Measure scores of 122 vs 115 respectively; P = 0.0937) and the incidence rate (95% confidence intervals) of presentation to the emergency department was sevenfold higher for Indigenous than non-Indigenous participants (11.47 (5.93–20.03) vs 1.65 (0.79–3.04) per 1000 person days respectively). Finally, 61.3% of participants required support to remain living in the community and 44% accessed allied health, with podiatry the most common intervention. The findings indicate that previous hospital utilisation is not a consistent indicator of complexity. Multimorbidity, cultural context and the living and caring situation are considered as matters of complexity, yet variation exists at the participant level.

Item ID: 66029
Item Type: Article (Research - C1)
ISSN: 1836-7399
Keywords: complex, context, GP, multimorbidity, older person.
Copyright Information: Journal compilation © La Trobe University 2021.
Funders: North Queensland Primary Health Network, Queensland Health Clinical Excellence Division
Date Deposited: 21 Jul 2021 04:08
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420399 Health services and systems not elsewhere classified @ 100%
SEO Codes: 20 HEALTH > 2003 Provision of health and support services > 200302 Community health care @ 33%
20 HEALTH > 2003 Provision of health and support services > 200310 Primary care @ 34%
20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200502 Health related to ageing @ 33%
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