Health outcomes in aged care residents with dementia during the COVID-19 pandemic

The onset of the COVID-19 pandemic had a significant impact on the way Australians accessed health services, including Medicare-subsidised general practitioner (GP) and medical specialist services. For example, the introduction of telehealth items provided more options for the delivery of Medicare services. For more information on changes across the Australian population during the COVID-19 pandemic, see Impact on MBS utilisation (AIHW 2022). 

It should be noted that the data in this section only include services receiving a Medicare rebate. People may also access services outside of the Medicare system. 

GP services for aged care residents

One in 3 residents with a dementia record had a telehealth GP attendance early in the pandemic

COVID-19 telehealth items were introduced into Medicare at different stages from 13 March 2020, with the aim of reducing the risk of transmission of COVID-19 by providing telephone and video conferencing options for consultations (AIHW 2022). In addition, schedule fees for bulk billing incentive items for non-referred services (such as GP services for patients in an aged care facility) were doubled until 1 October 2020.

• Early in the pandemic (in the June 2020 quarter), 33% of residents with a dementia record and 37% of residents with no dementia record had a telehealth GP attendance (Figure 1.1, ‘Percentage’) 
• The use of telehealth GP attendances by residents with and without a dementia record fluctuated with COVID-19 waves (see Figure A2): decreasing from late 2020 until the June 2021 quarter (the start of the Delta wave) then increasing to a peak in the March 2022 quarter (the start of the Omicron wave) (Figure 1.1). 
• Face-to-face GP attendance remained steady at about 90% of residents per quarter for people with and without a dementia record, peaking at about 93% in the June 2022 quarter (Figure 1.1). 

The highest number of telehealth GP attendances per resident was seen early in the pandemic

The following rates refer to aged care residents with at least one GP attendance, by dementia status; rates for all residents can be found in Table S1.1. 

After the introduction of telehealth items in March 2020, the average number of telehealth GP attendances per resident peaked in the September 2020 quarter at 3.3 per quarter for residents with a dementia record and 3.4 per quarter for residents with no dementia record (Figure 1.1, ‘Number’).

During this time, the average number of face-to-face GP attendances per person decreased from 7.2 to 6.7 per quarter for residents with a dementia record, and from 7.3 to 7.0 per quarter for residents with no dementia record (Figure 1.1).

The lowest average number of face-to-face GP attendances per person for residents with a dementia record was 6.1 per quarter in the March 2022 quarter, at the start of the Omicron period. This corresponded with the highest percentage of residents with a telehealth GP attendance (37%) (Figure 1.1).

For downloadable data tables, see Table S1.1 in Data tables (Changes in health service use by aged care residents).

Differences in GP attendances by population group

Figure 1.2 is an interactive chart where readers can explore differences in GP attendances, by dementia status and for selected population groups: sex, age group and region of residence (state or territory, remoteness area and socioeconomic area).

Some key findings are:

• Early in the pandemic, Victoria had the highest percentage of aged care residents with a telehealth GP attendance, peaking at 53% of residents with and without a dementia record in the September 2020 quarter (Figure 1.2, ‘Percent’). Over time, the percentage of residents with a telehealth GP attendance increased in each state or territory as the COVID-19 virus spread – in the September 2021 quarter for residents in NSW and ACT, and the March 2022 quarter for the remaining jurisdictions.
• The percentage of aged care residents who had a telehealth GP attendance was highest in Major cities and lowest in Remote areas: for example, 37% and 18%, respectively, of people with a dementia record in the June 2022 quarter (Figure 1.2, ‘Percent’)
• The percentage of aged care residents who had a telehealth GP attendance was highest in higher socioeconomic (least disadvantaged) areas and lowest in lower socioeconomic (most disadvantaged) areas (Figure 1.2, ‘Percent’).

For downloadable data tables, see Table S1.1 in Data tables (Changes in health service use by aged care residents).