Aim: To assess the effectiveness of primary and selected specialist services on health outcomes of new aged care residents.

Methods: Using the Registry of Senior Australians Historical Cohort, 358,354 individuals entering residential care (1/1/2013-31/12/2019) were studied. Utilisation of primary and specialist services, general practitioner (GP) continuity of care and patterns of service utilisation 12 months after care entry were examined. Outcomes examined include mortality, emergency department presentations, potentially preventable hospitalisations, unplanned hospitalisations, falls, fractures, medication-related adverse events, pressure injuries, malnutrition, and dementia/delirium-related hospitalisations were examined. Propensity score methods for confounding adjustment and survival analyses (Cox and Fine and Gray models) were employed.

Results: Continuity of care and patterns of service use offered significant benefits. Residents who continued to see their usual had a lower risk of emergency department presentations (8%), unplanned hospitalisations (8%), falls (11%), malnutrition (12%), and dementia/delirium (21%) hospitalisations than those that did not. Individuals with high use of preventive services trajectories (i.e., health assessments, management plans, and allied health), low-moderate use of other primary and specialist services and low urgent after hours attendances, had lower risk of mortality and most other outcomes examined compared to those with other service use patterns. Nurse practitioner attendances, optometrical services, medicines reviews, health assessments, GP management plans, and podiatry attendances were associated with lower premature mortality and some examined outcomes.

Conclusion: Continuity of care and primary care service utilisation that focuses on prevention and disease management are effective in improving health outcomes following residential care entry.