The impact of primary health care services, continuity of care and patterns of care on mortality and hospitalisation-related outcomes in residents of long-term care facilities: a comprehensive national evaluation.
Introduction High-quality evidence on the benefits of primary care in long-term care (LTC) is lacking. This study investigated the effect of primary health care services, continuity of care and care patterns on the risk of mortality and hospitalisation-related outcomes in LTC facility residents. Met...
| Publicado en: | Age & Ageing Vol. 55; no. 2; pp. 1 - 13 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Feb2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513154&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513154 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2026 vid: 55 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513154 10.1093/ageing/afag026 ppf: 1 ppct: 12 formats: tig: atl: The impact of primary health care services, continuity of care and patterns of care on mortality and hospitalisation-related outcomes in residents of long-term care facilities: a comprehensive national evaluation. aug: au: Inacio, Maria C Schwabe, Johannes Crotty, Maria Williams, Helena Wesselingh, Steve L Kellie, Andrew Roder, David Nixon, Krystal-Lee Harvey, Gillian Sluggett, Janet K affil: Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, AustraliaRegistry of Senior Australians Research Centre, Caring Futures Institute, Flinders University, Adelaide, South Australia, AustraliaUniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia Department of Rehabilitation, Aged and Extended Care, Flinders University, Bedford Park, South Australia, Australia Silverchain, Adelaide, South Australia, Australia South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia East Adelaide Healthcare, Adelaide, South Australia, Australia UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia SA Health Dental Service, Adelaide, South Australia, Australia College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, AustraliaUniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia su: Medical quality control Primary health care Hospital care Retrospective studies Psychosocial factors Mortality risk factors Risk assessment Nursing home residents Research funding Long-term health care Continuum of care Reporting of diseases Descriptive statistics Longitudinal method Kaplan-Meier estimator Medical records Acquisition of data Health outcome assessment Confidence intervals Proportional hazards models Regression analysis sug: subj: Medical quality control Primary health care Hospital care Retrospective studies Psychosocial factors Mortality risk factors Risk assessment Nursing home residents Research funding Long-term health care Continuum of care Reporting of diseases Descriptive statistics Longitudinal method Kaplan-Meier estimator Medical records Acquisition of data Health outcome assessment Confidence intervals Proportional hazards models Regression analysis keyword: continuity of patient care copyrightHolder:British Geriatrics Society copyrightYear:2026 death delirium dementia hospitalisation hospitalization https://dx.doi.org/10.1093/ageing/afag026 inbred shr inLanguage:en internship and residency long-term care malnutrition medical residencies mortality older people premature primary health care publisher:Oxford University Press rats risk reduction sameAs:https://pubmed.ncbi.nlm.nih.gov/41719422/ continuity of patient care copyrightHolder:British Geriatrics Society copyrightYear:2026 death delirium dementia hospitalisation hospitalization https://dx.doi.org/10.1093/ageing/afag026 inbred shr inLanguage:en internship and residency long-term care malnutrition medical residencies mortality older people premature primary health care publisher:Oxford University Press rats risk reduction sameAs:https://pubmed.ncbi.nlm.nih.gov/41719422/ ab: Introduction High-quality evidence on the benefits of primary care in long-term care (LTC) is lacking. This study investigated the effect of primary health care services, continuity of care and care patterns on the risk of mortality and hospitalisation-related outcomes in LTC facility residents. Methods A retrospective cohort study of 358 354 residents of 2948 LTC facilities across Australia was conducted (1 January 2013–31 December 2019). Primary care services, general practitioner (GP) continuity of care, and care patterns were examined. One-year risk of all-cause/premature mortality and nine hospitalisation measures were investigated. Propensity-score–adjusted survival models were employed. Results Residents with a care pattern inclusive of high preventive health services utilisation and low urgent after-hours attendances had lower risks of mortality [vs. high overall use, hazard ratio (HR) = 0.91, 95% confidence interval (CI) = 0.88–0.94; vs. high reactive use, HR = 0.91, 95% CI = 0.88–0.94] and most outcomes examined [e.g. fractures, subdistribution hazard ratio (sHRs) range = 0.90–0.91, 95% CI range = 0.84–0.97] compared to those with other care patterns. Residents who continued to see their usual GP had a lower risk of emergency department presentations (sHR = 0.92, 95% CI= 0.90–0.94), unplanned hospitalisations (sHR = 0.94, 95% CI= 0.92–0.96), falls (sHR = 0.89, 95% CI= 0.86–0.92), malnutrition (sHR = 0.88, 95% CI= 0.82–0.96), and dementia/delirium hospitalisations (sHR = 0.79, 95% CI= 0.72–0.87) than those who did not. Nurse practitioner attendances, optometrical services, comprehensive medication reviews, health assessments, management plans and podiatry attendances on their own were associated with lower premature mortality and some hospitalisation-related outcomes. Conclusions Care patterns focusing on prevention and disease management, GP continuity of care and certain primary care services can positively impact residents' health and outcomes in LTC facilities. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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