Geographical variation in health service use by people living with dementia

This report explores the use of residential respite care among 2 groups of people living with dementia (see Methods section):

• “Community 2019” group: people living in the community in 2019, who did not enter permanent residential aged care in 2019 or 2020.
• “Subsequent PRAC” group: people living in the community for all or some of 2019, who did enter permanent residential aged care later in 2019 or in 2020.

The use of residential respite care by people who did not enter permanent care in the subsequent 12 months was low overall (an average 5.4% of people). Within Major cities, after adjusting for differences in age, people in the highest socioeconomic areas had significantly higher rates of residential respite care use (3.6 per 100 people with a dementia record) than those in the lowest socioeconomic areas (1.9 per 100 people with a dementia record).

The use of residential respite care was more common for people who did enter permanent care in the subsequent 12 months. 

• Within Major cities, rates were highest in the highest socioeconomic areas (75%) but were similar across other socioeconomic areas (between 69%–71%).
• Outside major cities, rates were highest in the lower socioeconomic areas (between 68%–72%) and lowest in the highest socioeconomic areas (62%). Overall, use of residential respite care was lower than within Major cities.

For both groups, people who used residential respite care had an average of 1.5 stays per person (see Table S5.1 for details).

Figure 3.4: Residential respite care use among people in the dementia cohort, by place of residence, socioeconomic area (Total, within Major cities and Outside major cities) and sex, 2019­–2020

Notes

1. The dementia study cohort refers to 158,730 people aged 30 and over who were living in Australia in 2019 and had a dementia record in the NIHSI. Western Australia and the Northern Territory were excluded from all analyses because their hospital data were not available for construction of the cohort.
2. The geographies in this report are based on where a person lived, not where they received services.
3. PRAC = permanent residential aged care
4. ‘Percentage’ is the proportion of people in the dementia cohort with at least one service recorded in the NIHSI in 2019.
5. Rate ratios are a method for comparing rates between regions. The rates for people living with dementia in the highest socioeconomic areas were used as the reference population to compare with other socioeconomic areas (‘Quintile 5 – highest’ for the total cohort, ‘Major cities – quintile 5 – highest’ for analysis within and Outside Major cities). A rate ratio of 1 indicates that the rate for the region is the same as the rate in the reference population. A rate ratio greater than 1 indicates that the rate for the region is higher than the rate in the reference population. A rate ratio less than 1 indicates that the rate for the region is lower than the rate in the reference population.
6. Age-standardised rates were calculated where population and service counts allowed.
7. “Mean (service users)” is the mean number of attendances per person for people in the dementia cohort who used the service at least once in 2019.
8. The bar is blank if a value could not be published due to data quality or confidentiality concerns.

Data tables: Residential respite care use among people in the dementia cohort