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Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users
Monica Cations, Catherine E. Lang, Stephanie Alison Ward, Gillian Elizabeth Caughey, Maria Crotty, Craig Whitehead, Susannah Ahern, John Maddison et al.. Scientific Reports, 2021-05-21
Topic: Risk, prevention and care in population studies
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.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Cations, M., Lang, C. E., Ward, S. A., Caughey, G. E., Crotty, M., Whitehead, C., et al. (2021). Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users. Scientific Reports. https://doi.org/10.1038/s41598-021-89646-x
Vancouver
Cations M, Lang CE, Ward SA, Caughey GE, Crotty M, Whitehead C, et al. Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users. Scientific Reports. 2021. doi:10.1038/s41598-021-89646-x. PMID: 34021203.
BibTeX
@article{cations2021-34021203,
author = {Cations, Monica and Lang, Catherine E. and Ward, Stephanie Alison and Caughey, Gillian Elizabeth and Crotty, Maria and Whitehead, Craig and Ahern, Susannah and Maddison, John and others},
title = {{Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users}},
journal = {Scientific Reports},
year = {2021},
doi = {10.1038/s41598-021-89646-x},
pmid = {34021203},
url = {https://doi.org/10.1038/s41598-021-89646-x}
}
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Key findings
- 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.
Why it matters
Among Australian aged care users with dementia, four indicators of dementia care quality changed little over time, with only a slight decrease in antipsychotic dispensing and a slight increase in high sedative load and dementia and delirium-related hospitalisations, plus marked geographic variation in cholinesterase inhibitor and memantine dispensing. The authors conclude that existing strategies to improve national performance on these indicators appear insufficient, so this is about care quality, not treating, curing, or preventing dementia.
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Study details
- Study designcohort study
- Participants373,695
- Effect sizeRR = 1.02; RR = 1.01
- Evidence strengthModerate
How this study scored 58/100
Published in a peer-reviewed journal, and it is a cohort study following people over 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 (Scientific Reports) |
| Journal's citation record | 3 / 4 | Scientific Reports: journal h-index 463 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 373,695 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 9 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 1 / 6 | Cited 1.0× 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 5 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 9 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 34021203) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
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Read the original
- DOI: 10.1038/s41598-021-89646-x
- PubMed: 34021203
- Original source →
- Free full text: Scientific Reports →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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