Publications by authors named "Wesselingh S"
Article Synopsis
- This study analyzed the performance of long-term care services (LTCS) in Australia, focusing on 12 quality indicators to determine achievable benchmarks of care (ABC©) based on top-performing facilities.
- The research included data from 2,746 LTCS and over 244,000 residents aged 65 and older in 2019, revealing that certain quality indicators had low benchmark rates, with 17-59% of LTCS meeting ABC for severe health concerns.
- Results showed that smaller and government-owned LTCS were more likely to achieve these benchmarks, highlighting the importance of these characteristics for quality care delivery.
Background: The impact of Home Medicines Reviews (HMRs) on long-term health outcomes among individuals receiving long-term in-home aged care services is unknown.
Objectives: To examine associations between HMR provision and hospitalization, long-term care facility (LTCF) entry and mortality among older people receiving long-term in-home aged care services.
Methods: This retrospective cohort study included individuals aged 65-105 years from three Australian states who accessed in-home aged care services between 2013 and 2017.
Article Synopsis
- * A study compared the gut microbiomes of aged care residents with and without a UTI history and found that prior UTI history did not significantly impact microbiome composition, although prior UTIs were a predictor of future infections.
- * The research suggested that there is no clear link between gut microbiota and UTI incidence in older adults, potentially due to high exposure to antibiotics and age-related factors affecting gut health.
Article Synopsis
- High antibiotic prescriptions in aged care could lead to increased antibiotic-resistant pathogens in residents, raising concerns about treatment failures.
- A study analyzed stool samples from 164 residents in South Australia, linking antibiotic use over the past year to the presence and quantity of antibiotic resistance genes (ARGs).
- Findings revealed that over 1100 unique ARGs were identified, with doxycycline being a major risk factor for high ARG levels, particularly influencing resistance to penicillins and cephalosporins, highlighting the need for cautious antibiotic use in this population.
Objectives: To assess changes following the 2013-21 Home Care Package (HCP) reforms in the rate of HCPs provided to Australians aged 65 years or older, the characteristics of people who have received HCPs, and the capacity of the program to meet demand for its services during 2018-21.
Study Design: Repeated cross-sectional population-based study; analysis of Australian Institute of Health and Welfare GEN Aged Care and Australian Department of Health Home Care Packages program data.
Setting, Participants: HCPs provided to non-Indigenous Australians aged 65 years or older, 2008-09 to 2020-21.
Aged care service use by Aboriginal and Torres Strait Islander people after aged care eligibility assessments, 2017-2019: a population-based retrospective cohort study.
Med J Aust
July 2024
Objective: To characterise the socio-demographic characteristics, aged and health care needs, and aged care services used by older Aboriginal and Torres Strait Islander people assessed for aged care service eligibility.
Study Design: Population-based retrospective cohort study; analysis of Registry of Senior Australians (ROSA) National Historical Cohort data.
Setting, Participants: Aboriginal and Torres Strait Islander people aged 50 years or older who were first assessed for aged care service eligibility (permanent residential aged care, home care package, respite care, or transition care) during 1 January 2017 - 31 December 2019.
Objective: Population-based data on the required needs for palliative care in residential aged care have been highlighted as a key information gap. This study aimed to provide a comprehensive estimate of palliative care needs among Australia's residential aged care population using a validated algorithm based on causes of death.
Methods: A population-based retrospective cohort study was conducted using data from the Registry of Senior Australians of non-Indigenous residents of residential aged care services in New South Wales, Victoria, and South Australia aged older than 65 years, who died between 2016 and 2017 (n = 71,677).
Article Synopsis
- Probiotics are being studied for their potential health benefits, but their effectiveness varies greatly among individuals.
- A study investigated whether a genetic variant influencing mucosal α(1,2)-fucosylated glycan production affects how different mice respond to probiotics, particularly Bifidobacterium strains.
- Results showed that mice with the genetic variant (Fut2WT) had better retention of B. infantis after antibiotics, while those without it (Fut2KO) had different persistence patterns, emphasizing the impact of genetics and gut conditions on probiotic effectiveness.
Objective: The objective of this review is to identify quality indicators used to monitor the quality and safety of care provided to older people (≥ 65 years old) in 8 care settings: primary care; hospital/acute care; aged care (including residential aged care and home or community care); palliative care; rehabilitation care; care transitions; dementia care; and care in rural areas.
Introduction: There is a need for high-quality, holistic, person-centered care for older people. Older people receive care across multiple care settings, and population-level monitoring of quality and safety of care across settings represents a significant challenge.
ObjectiveThis study aimed to examine the national variation in government-subsidised healthcare costs of residents in long-term care facilities (LTCFs) and costs differences by resident and facility characteristics.MethodsA retrospective population-based cohort study was conducted using linked national aged and healthcare data of older people (≥65years) living in 2112 LTCFs in Australia. Individuals' pharmaceutical, out-of-hospital, hospitalisation and emergency presentations direct costs were aggregated from the linked healthcare data.
View Article and Find Full Text PDFObjective: Moving into a long-term care facility (LTCF) requires substantial personal, societal and financial investment. Identifying those at high risk of short-term mortality after LTCF entry can help with care planning and risk factor management. This study aimed to: (i) examine individual-, facility-, medication-, system- and healthcare-related predictors for 90-day mortality at entry into an LTCF and (ii) create risk profiles for this outcome.
View Article and Find Full Text PDFObjectives: To examine changes in primary, allied health, selected specialists, and mental health service utilisation by older people in the year before and after accessing home care package (HCP) services.
Methods: A retrospective cohort study using the Registry of Senior Australians Historical National Cohort (≥ 65 years old), including individuals accessing HCP services between 2017 and 2019 (N = 109,558), was conducted. The utilisation of general practice (GP) attendances, health assessments, chronic disease management plans, allied health services, geriatric, pain, palliative, and mental health services, subsidised by the Australian Government Medicare Benefits Schedule, was assessed in the 12 months before and after HCP access, stratified by HCP level (1-2 vs.
Objective The study examined emergency department (ED) presentations, unplanned hospitalisations and potentially preventable hospitalisations in older people receiving long-term care by type of care received (i.e. permanent residential aged care or home care packages in the community), in Australia in 2019.
View Article and Find Full Text PDFBackground: Stratifying residents at increased risk for fractures in long-term care facilities (LTCFs) can potentially improve awareness and facilitate the delivery of targeted interventions to reduce risk. Although several fracture risk assessment tools exist, most are not suitable for individuals entering LTCF. Moreover, existing tools do not examine risk profiles of individuals at key periods in their aged care journey, specifically at entry into LTCFs.
View Article and Find Full Text PDFBackground: To date, the excess mortality experienced by residential aged care facility (RACF) residents related to COVID-19 has not been estimated in Australia. This study examined (i) the historical mortality trends (2008-09 to 2021-22) and (ii) the excess mortality (2019-20 to 2021-22) of Australian RACF residents.
Methods: A retrospective population-based study was conducted using the Australian Institute of Health and Welfare's GEN website data (publicly available aged care services information).
Objectives: To examine the historical trends and predict the future rates and total volumes of permanent residential aged care (PRAC) service utilization in Australia.
Design: A population-based repeated cross-sectional and projection study of non-indigenous older people (≥65 years) accessing PRAC in Australia was conducted.
Setting And Participants: Publicly available aged care admissions from the Australian Institute of Health and Welfare and population estimates from the Australian Bureau of Statistics were used.
Objectives: To examine utilisation of primary health care services (subsidised by the Australian Government, Medicare Benefits Schedule, MBS) before and after entry into long-term care (LTC) in Australia.
Methods: A retrospective cohort study of older people (aged ≥65 years) who entered LTC in Australia between 2012 and 2016 using the Historical Cohort of the Registry of Senior Australians. MBS-subsidised general attendances (general practitioner (GP), medical and nurse practitioners), health assessment and management plans, allied health, mental health services and selected specialist attendances accessed in 91-day periods 12 months before and after LTC entry were examined.
Article Synopsis
- The GRACE study was initiated to understand antimicrobial resistance in residential aged care facilities, focusing on key risk factors and transmission methods.
- A total of 279 participants, primarily elderly (median age 88.6 years), were recruited from five South Australian facilities, with many having cognitive impairments and prior antibiotic exposure.
- The study's cohort closely mirrors the national aged care population in demographics and health conditions, highlighting differences in care needs and antibiotic use compared to historical data.
Article Synopsis
- Multidrug-resistant organisms (MDROs) pose a significant global health challenge, especially in low and middle-income countries due to factors like poor antibiotic regulation and sanitation.
- The problem is often seen as a threat primarily to countries where MDROs are not common, while the real impact is felt by individuals moving from high MDRO areas to places where standard treatments still work.
- The article suggests implementing screening strategies based on future infection risks during critical healthcare moments, rather than focusing on patients' origins, to avoid stigmatization and improve treatment outcomes for vulnerable populations.
Objectives: To examine the incidence and trends in primary care, allied health, geriatric, pain and palliative care service use by permanent residential aged care (PRAC) residents and the older Australian population.
Methods: Repeated cross-sectional analyses on PRAC residents (N = 318,484) and the older (≥65 years) Australian population (N ~ 3.5 million).
COVID-19 has had a significant impact on the global population and has produced compelling evidence of non-pulmonary organ dysfunction, including the nervous system. It is vital that specialists in ophthalmology and neurology are informed of the potential complications of COVID-19 and gain a deeper understanding of how COVID-19 can cause diseases of the nervous system. In this review we detail four possible mechanisms by which COVID-19 infection may result in neurological or neuro-ophthalmological complications: (1) Toxic and metabolic effects of severe pulmonary COVID-19 disease on the neural axis including hypoxia and the systemic hyper-inflammatory state, (2) endothelial dysfunction, (3) dysimmune responses directed again the neuroaxis, and (4) direct neuro-invasion and injury by the virus itself.
View Article and Find Full Text PDFBackground: In Australia, 243 000 individuals live in approximately 2700 residential aged care facilities yearly. In 2019, a National Aged Care Mandatory Quality Indicator programme (QI programme) was implemented to monitor the quality and safety of care in facilities.
Aim: To examine the validity of the QI programme indicators using explicit measure review criteria.