Patterns of home and community care use among older participants in the Australian Longitudinal Study of Women’s Health

  • Mijanur RahmanEmail author
  • Jimmy T. Efird
  • Hal Kendig
  • Julie E. Byles
Original Investigation


The aims of this study were to investigate patterns of home and community care (HACC) use and to identify factors influencing first HACC use among older Australian women. Our analysis included 11,133 participants from the Australian Longitudinal Study of Women’s Health (1921–1926 birth cohort) linked with HACC use and mortality data from 2001 to 2011. Patterns of HACC use were analysed using a k-median cluster approach. A multivariable competing risk analysis was used to estimate the risk of first HACC use. Approximately 54% of clients used a minimum volume and number of HACC services; 25% belonged to three complex care use clusters (referring to higher volume and number of services), while the remainder were intermediate users. The initiation of HACC use was significantly associated with (1) living in remote/inner/regional areas, (2) being widowed or divorced, (3) having difficulty in managing income, (4) not receiving Veterans’ Affairs benefits, (5) having chronic conditions, (6) reporting lower scores on the SF-36 health-related quality of life, and (7) poor/fair self-rated health. Our findings highlight the importance of providing a range of services to meet the diverse care needs of older women, especially in the community setting.


Home and community care Demographic factors Health-related needs Older women Data linkage Australia 



This study was conducted as part of the Australian Longitudinal Study on Women’s Health, University of Newcastle and University of Queensland. The authors are grateful to the Australian Government Department of Health for funding and for providing permission to access the aged care datasets, and to the women who provided the survey data. The authors acknowledge the assistance of the data linkage unit at the Australian Institute of Health and Welfare (AIHW) for undertaking the data linkage to the National Death Index (NDI) and administrative aged care data.

Compliance with ethical standards

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Mijanur Rahman
    • 1
    • 2
    • 3
    Email author
  • Jimmy T. Efird
    • 1
    • 2
  • Hal Kendig
    • 4
  • Julie E. Byles
    • 1
    • 2
  1. 1.Priority Research Centre for Generational Health and Ageing, School of Medicine and Public HealthHunter Medical Research Institute, University of NewcastleNew Lambton HeightsAustralia
  2. 2.Centre for Clinical Epidemiology and Biostatistics, University of NewcastleNew Lambton HeightsAustralia
  3. 3.Department of StatisticsComilla UniversityComillaBangladesh
  4. 4.Research School of Population HealthAustralian National UniversityCanberraAustralia

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