title: Assessing patterns of home and community care service use and client profiles in Australia: a cluster analysis approach using linked data.
abstract: The planning and delivery of care systems require knowledge on the ways in which individuals access available services that are funded by a range of health and community services. The aims of this study were to identify distinct groups of Home and Community Care (HACC) clients in New South Wales, Australia, based on patterns of actual service use, and to understand the health and social needs and resources of client groups that access different mixes of services. Multiple data sets linked at the individual level - including the 45 and Up Study community survey, the HACC Minimum Data Set and the Admitted Patient Data Collection for hospitals - provide an innovative basis to investigate the complexity of access to service use. Data were collected between 2006 and 2008. A cluster analysis based on clients' type and volume of community service use was conducted on the 4890 HACC clients in the linked dataset and nine distinct clusters of clients were identified. Three of these clusters were considered 'complex', in terms of the range of community and hospital assistance received, while the others comprised mainly of one or two dominant service types. The analytical approach and findings developed here provide a client-centred approach to monitor and evaluate access to local service systems that are being reformed to better integrate the delivery of health and community services currently funded and managed separately by national and state governments.
authors: Ageing, Work, and Health Research Unit, University of Sydney, Australia. hal.kendig@sydney.edu.au
authors: Hal
authors: H
authors: Kendig
authors: Nicole
authors: N
authors: Mealing
authors: Rachel
authors: R
authors: Carr
authors: Sanja
authors: S
authors: Lujic
authors: Julie
authors: J
authors: Byles
authors: Louisa
authors: L
authors: Jorm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D015331:Cohort Studies; D003153:Community Health Services / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales