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Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses
Gillian Elizabeth Caughey, Catherine E. Lang, Sarah Catherine Elizabeth Bray, Janet Kathleen Sluggett, Craig Whitehead, Renuka Visvanathan, Keith E. Evans, Megan E. Corlis et al.. BMJ Open, 2022-08-01
Topic: Risk, prevention and care in population studies
Objectives To develop and examine the prevalence of quality and safety indicators to monitor care of older Australians receiving home care packages (HCPs), a government-funded aged care programme to support individuals to live at home independently. Design Cross-sectional. Setting Home care recipients, Australia. Participants 90 650 older individuals (aged ≥65 years old and ≥50 years old for people of Aboriginal or Torres Strait Islander descent) who received a HCP between 1 January 2016 and 31 December 2016 nationally were included. Primary and secondary outcome measures The Registry of Senior Australians developed 15 quality and safety indicators: antipsychotic use, high sedative load, chronic opioid use, antimicrobial use, premature mortality, home medicines reviews, chronic disease management plan, wait-time for HCP, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium/dementia-related hospitalisations, emergency department (ED) presentations and pressure injuries. Risk adjusted prevalence (%, 95% CI) and geographical area (statistical level 3) variation during 2016 were examined. Results In 2016, a total of 102 590 HCP episodes were included for 90 650 individuals, with 66.9% (n=68 598) level 1–2 HCP episodes (ie, for basic care needs) and 33.1% (n=33 992) level 3–4 HCP (ie, higher care needs). The most prevalent indicators included: antibiotic use (52.4%, 95% CI 52.0 to 52.7), chronic disease management plans (38.1%, 95% CI 37.8 to 38.4), high sedative load (29.1%, 95% CI 28.8 to 29.4) and ED presentations (26.4%, 95% CI 25.9 to 26.9). HCP median wait time was 134 days (IQR 41–406). Geographical variation was highest in chronic disease management plans and ED presentations (20.7% of areas outside expected range). Conclusion A comprehensive outcome monitoring system to monitor the quality and safety of care and variation for HCP recipients was developed. It provides a pragmatic, efficient and low burden tool to support evidence-based quality and safety improvement initiatives for the aged care sector.
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APA 7th
Caughey, G. E., Lang, C. E., Bray, S. C. E., Sluggett, J. K., Whitehead, C., Visvanathan, R., et al. (2022). Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses. BMJ Open. https://doi.org/10.1136/bmjopen-2022-063152
Vancouver
Caughey GE, Lang CE, Bray SCE, Sluggett JK, Whitehead C, Visvanathan R, et al. Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses. BMJ Open. 2022. doi:10.1136/bmjopen-2022-063152.
BibTeX
@article{caughey2022-e245af65,
author = {Caughey, Gillian Elizabeth and Lang, Catherine E. and Bray, Sarah Catherine Elizabeth and Sluggett, Janet Kathleen and Whitehead, Craig and Visvanathan, Renuka and Evans, Keith E. and Corlis, Megan E. and others},
title = {{Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses}},
journal = {BMJ Open},
year = {2022},
doi = {10.1136/bmjopen-2022-063152},
url = {https://doi.org/10.1136/bmjopen-2022-063152}
}
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Key findings
- Results In 2016, a total of 102 590 HCP episodes were included for 90 650 individuals, with 66.9% (n=68 598) level 1–2 HCP episodes (ie, for basic care needs) and 33.1% (n=33 992) level 3–4 HCP (ie, higher care needs).
Why it matters
This cross-sectional study developed quality and safety indicators for older Australians receiving government-funded home care packages. It is about monitoring home care, not about treating, curing or preventing Alzheimer's disease.
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Study details
- Study designcross-sectional
- Participants68
- Effect size66.9%; 33.1%; 52.4%
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMJ Open) |
| Journal's citation record | 2 / 4 | BMJ Open: journal h-index 240 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 1 / 4 | 68 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 11 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.8 citations a year over 6 year(s) since 2022 |
| Impact for its field and year | 2 / 6 | Cited 2.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Maria C S Inacio: h-index 58 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Monash University: institution h-index 1,146 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
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