Cations Monica, Lang Catherine E, Ward Stephanie A, Crotty Maria, Whitehead Craig, Maddison John, Inacio Maria
Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
BMJ Open. 2021 Feb 1;11(2):e039907. doi: 10.1136/bmjopen-2020-039907.
Clinical quality registries (CQRs) are being established in many countries to monitor, benchmark, and report on the quality of dementia care over time. Case ascertainment can be challenging given that diagnosis occurs in a variety of settings. The Registry of Senior Australians (ROSA) includes a large cohort of people with dementia from all Australian states and territories identified using routinely collected aged care assessment data. In ROSA, assessment data are linked to information about aged and health service use, medicine dispensing, hospitalisations and the National Death Index. The ROSA dementia cohort was established to capture people for the Australian dementia CQR currently in development who may not be identified elsewhere.
There were 373 695 people with dementia identified in aged care assessments from 2008 to 2016. Cross-sectional analysis from the time of cohort entry (e.g. when first identified with dementia on an aged care assessment) indicates that individuals were 84.1 years old on average, and 63.1% were female. More than 44% were first identified at entry to permanent residential aged care. The cohort recorded more severe cognitive impairment at entry than other international dementia registries.
The cohort has so far been used to demonstrate a declining prevalence of dementia in individuals entering the aged care sector, examine trends in psychotropic medicine prescribing, and to examine the impact of dementia on aged care service use and outcomes.
The ROSA dementia cohort will be updated periodically and is a powerful resource both on its own and as a contributor to the Australian dementia CQR. Integration of the ROSA dementia cohort with the dementia CQR will ensure that people with dementia using aged care services can benefit from the ongoing monitoring and benchmarking of care that a registry can provide.
许多国家正在建立临床质量登记系统(CQRs),以长期监测、评估和报告痴呆症护理质量。鉴于痴呆症诊断发生在多种环境中,病例确定可能具有挑战性。澳大利亚老年人登记系统(ROSA)纳入了一大批来自澳大利亚所有州和领地的痴呆症患者,这些患者是通过常规收集的老年护理评估数据确定的。在ROSA中,评估数据与有关老年和医疗服务使用、药物配给、住院情况以及国家死亡指数的信息相关联。建立ROSA痴呆症队列是为了纳入目前正在开发的澳大利亚痴呆症CQRs中可能在其他地方未被识别的患者。
2008年至2016年期间,在老年护理评估中确定了373695名痴呆症患者。队列进入时(例如在老年护理评估中首次被诊断为痴呆症时)的横断面分析表明,个体平均年龄为84.1岁,63.1%为女性。超过44%的患者在进入永久性老年居住护理机构时首次被确诊。该队列在进入时记录的认知障碍比其他国际痴呆症登记系统更为严重。
到目前为止,该队列已被用于证明进入老年护理部门的个体中痴呆症患病率呈下降趋势,研究精神药物处方趋势,并研究痴呆症对老年护理服务使用和结果的影响。
ROSA痴呆症队列将定期更新,它本身就是一个强大的资源,也是澳大利亚痴呆症CQRs的一个贡献者。将ROSA痴呆症队列与痴呆症CQRs整合,将确保使用老年护理服务的痴呆症患者能够从登记系统提供的持续护理监测和评估中受益。