Allied health service delivery in residential aged care and the impact of the coronavirus (COVID-19) pandemic: a survey of the allied health workforce
Isabelle Meulenbroeks A * , Magdalena Z. Raban A , Karla Seaman A , Nasir Wabe A and Johanna Westbrook AA
Abstract
Industry reports suggest that routine and essential care in Australian residential aged care (RAC), including allied health (AH) services, were disrupted during the coronavirus diseas 2019 (COVID-19) pandemic. This study aimed to explore whether AH services in RAC were paused during the pandemic, factors associated with a pause in care delivery, and qualitative details on how COVID-19 impacted AH service delivery.
A 26-question survey was distributed via social media, health service providers, and AH networks between February and April 2022. Participation was restricted to AH professionals and assistants with experience in RAC during the pandemic. A mix of closed and open-ended response questions was used to collect demographic data and experiences of delivering care during the pandemic. Quantitative responses were analysed with descriptive statistics and a probit model. Content analysis was performed on open-ended questions.
One hundred and four AH professionals and assistants responded to the survey. Fifty-five percent of participants (n = 51) were contractually or casually employed. AH services were negatively impacted by the pandemic with 52% of respondents experiencing a pause in service delivery and 78% reporting poorer AH care quality. In a probit model, contracted/casually employed respondents were more likely to experience a pause in care delivery (1.03, P < 0.05) compared to permanently employed AH professionals.
Insecure work arrangements may have exacerbated inconsistent care during the pandemic (impacting residents) and may have negative implications on the RAC AH workforce. In the future, an AH inclusive workforce policy including data collection and research is required to monitor and plan the RAC workforce.
Keywords: allied health, COVID-19, employment, health workforce, nutritionists, physical therapists, residential facilities, resource-limited settings, speech-language pathology.
References
1 Royal Commission into Aged Care Quality and Safety. Aged care and COVID-19: a speacil report. Canberra: Commonwealth of Australia; 2020. Available at https://agedcare.royalcommission.gov.au/sites/default/files/2020-10/aged-care-and-covid-19-a-special-report.pdf
2 Meulenbroeks I, Raban MZ, Seaman K, Westbrook J. Therapy-based allied health delivery in residential aged care, trends, factors, and outcomes: a systematic review. BMC Geriatr 2022; 22: 712.
| Crossref | Google Scholar | PubMed |
3 Fernández-Barrés S, García-Barco M, Basora J, Martínez T, Pedret R, Arija V, Project ATDOM-NUT group.. The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving Home Care: A randomized controlled trial. Int J Nurs Stud 2017; 70: 131-41.
| Crossref | Google Scholar | PubMed |
4 Frenkel H, Harvey I, Newcombe RG. Improving oral health in institutionalised elderly people by educating caregivers: a randomised controlled trial. Community Dent Oral Epidemiol 2001; 29: 289-97.
| Crossref | Google Scholar | PubMed |
5 Department of Health. 2020 Aged care workforce census report. Canberra: Australian Government; 2020. Available at https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf
6 Stewart Brown. 2020 Allied health deep dive survey. Sydney: Stewart Brown; 2020. Available at https://www.stewartbrown.com.au/images/documents/StewartBrown_Allied_Health_Deep_Dive_Survey__Feb_2021.pdf
7 Meulenbroeks I, Seaman K, Raban MZ, Westbrook J. Allied health in residential aged care: Using routinely collected data to improve funding opportunities. Australas J Ageing 2022; 1: 221-4.
| Crossref | Google Scholar | PubMed |
8 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377-81.
| Crossref | Google Scholar | PubMed |
9 Australian Bureau of Statistics. Labour Force, Australia methodlogy. Canberra: ABS; 2022. Available at https://www.abs.gov.au/methodologies/labour-force-australia-methodology/apr-2022
10 Mavromaras K, Knight G, Isherwood L, Crettenden A, Flavel J, Karmel T, et al. The aged care workforce, 2016. Canberra: Department of Health, Australian Government; 2017. Available at https://gen-agedcaredata.gov.au/www_aihwgen/media/Workforce/The-Aged-Care-Workforce-2016.pdf
11 Livingstone I, Hefele J, Nadash P, Barch D, Leland N. The relationship between quality of care, physical therapy, and occupational therapy staffing levels in nursing homes in 4 Years’ follow-up. J Am Med Dir Assoc 2019; 20: 462-9.
| Crossref | Google Scholar | PubMed |
12 Royal Commission into Aged Care Quality and Safety. Draft proposition - allied health. Canberra: Royal Commission into Aged Care Quality and Safety; 2020. Available at https://agedcare.royalcommission.gov.au/system/files/2020-07/RCD.9999.0343.0019_0.pdf
13 Turnbull C, Grimmer-Somers K, Kumar S, May E, Law D, Ashworth E. Allied, scientific and complementary health professionals: a new model for Australian allied health. Aust Health Rev 2009; 33: 27-37.
| Crossref | Google Scholar | PubMed |
14 Australian Bureau of Statistics. Australian Statistical Geography Standard (ASGS) Edition 3. Canberra: Australian Government; 2021. Available at https://www.abs.gov.au/statistics/standards/australian-statistical-geography-standard-asgs-edition-3/latest-release
15 Department of Health and Aged Care. Coronavirus (COVID-19) case numbers and statistics. Canberra: Australian Government; 2022. Available at https://www.health.gov.au/health-alerts/covid-19/case-numbers-and-statistics
16 National Skills Commission. Care workforce labour market study: final report. Canberra: Australian Government; 2021. Available at https://www.nationalskillscommission.gov.au/sites/default/files/2022-10/Care%20Workforce%20Labour%20Market% 20Study.pdf
18 Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open 2016; 2: 8-14.
| Crossref | Google Scholar |
20 Edmonds WA, Kennedy TD. An applied guide to research designs: quantitative, qualitative, and mixed methods. Thousand Oaks, CA: SAGE Publications, Inc; 2017. Available at https://methods.sagepub.com/book/an-applied-guide-to-research-designs-2e
21 Tuczyńska M, Staszewski R, Matthews-Kozanecka M, Żok A, Baum E. Quality of the Healthcare Services During COVID-19 Pandemic in Selected European Countries. Front Public Health 2022; 10: 870314.
| Crossref | Google Scholar | PubMed |
22 Meulenbroeks I, Seaman K, Raban MZ, Wabe N, Westbrook J. Just visiting: A qualitative study of Australian allied health professionals’ experiences working in residential aged care facilities during the COVID-19 pandemic. Australas J Ageing 2023; 1-8.
| Crossref | Google Scholar | PubMed |
23 Lystad RP, Brown BT, Swain MS, Engel RM. Impact of the COVID-19 Pandemic on Manual Therapy Service Utilization within the Australian Private Healthcare Setting. Healthcare 2020; 8: 558.
| Crossref | Google Scholar | PubMed |
24 Ward G, Casterton K. The impact of the COVID-19 pandemic on occupational therapy in the United Kingdom. London: Royal College of Occupational Therapists; 2020. Available at https://www.rcot.co.uk/sites/default/files/The_impact_of_the_COVID-19_pandemic_on_occupational_therapy_in_the_United_Kingdom_-_Survey_report.pdf
25 Williams CM, Couch A, Haines T, Menz HB. Experiences of Australian podiatrists working through the 2020 coronavirus (COVID-19) pandemic: an online survey. J Foot Ankle Res 2021; 14: 11.
| Crossref | Google Scholar | PubMed |
26 American Physical Therapy Association. Impact of COVID-19 on the Physical Therapy Profession: a report from the American Physical Therapy Association. 2020. Available at https://aptac.memberclicks.net/assets/APTA_impact-of-covid-19-on-physical-therapy-profession.pdf
27 Department of Health and Aged Care. Introduction of 24/7 onsite registered nurse and increased minimum care minutes requirements. Canberra: Australian Government; 2022. Available at https://oia.pmc.gov.au/sites/default/files/posts/2022/08/Supplementary%20Regulatory%20Impact%20Analysis%20-%2024-7%20Nurses%20Registered%20Nurses%20and%20Minimum%20Care%20Minutes.pdf
