Home care service utilisation by people with dementia—A retrospective cohort study of community nursing data in Australia

Joel M. van Weel, Emma Renehan, Kaye E. Ervin, Joanne Enticott

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6 Citations (Scopus)


Progressive aged care reforms are shifting dementia care into the community. These efforts have been shown to prevent transition to residential aged care facilities and hospitals. There is a paucity of studies examining the utilisation of home care services for people living with dementia. This study aims to address the current knowledge gap by providing a comprehensive summary of older adults receiving home care and comparing service use for people with and without dementia. A retrospective secondary data analysis was conducted using routine data prospectively collected from a cohort (n = 2,703 with dementia matched to 9,224 without dementia; total 11,927) using a community home nursing service in metropolitan Melbourne, Australia, in 2014. Descriptive statistics compared individuals with and without dementia on client-level demographics and their episode of home care service use. A comparative analysis on select variables was also performed using a conditional Poisson regression to estimate relative risk (RR). Compared to older adults without dementia, people with dementia were more likely to be born overseas (RR 1.10, 95% CI [1.03–1.19]), require an interpreter (RR 1.41, 95% CI [1.26–1.59]), and live with family (RR 1.09 [1.01–1.16]). When examining an individual's episode of care, people with dementia were more likely to require acute care (RR 1.07, 95% CI [1.01–1.14]) and be discharged from home care with personal care services (RR 1.46, 95% CI [1.24–1.72]). People with dementia were less likely to be referred from a hospital (RR 0.73, 95% CI [0.69–0.77]), achieve their home care goals (RR 0.91, 95% CI [0.87–0.94]), or die while in receipt of home care services (RR 0.82, 95% CI [0.72–0.94]). Our findings suggest that people with dementia have different socio-demographic characteristics and interactions with home care services compared to people without dementia.

Original languageEnglish
Pages (from-to)665-675
Number of pages11
JournalHealth and Social Care in the Community
Issue number3
Publication statusPublished - May 2019


  • Alzheimer disease
  • community services
  • dementia
  • health service use
  • home care

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