Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: A Multi-Center Audit Study

Journals of Gerontology - Series B: Psychological Sciences and Social Sciences, 17.08.2020, p. 1-35.

35 Pages Posted: 9 Oct 2020

See all articles by Craig Sinclair

Craig Sinclair

University of New South Wales (UNSW) - ARC Centre of Excellence in Population Ageing Research (CEPAR)

Marcus Sellars

affiliation not provided to SSRN

Kim Buck

affiliation not provided to SSRN

Karen Detering

Austin Health

Ben White

Queensland University of Technology - Faculty of Law

Linda Nolte

Austin Health

Date Written: August 17, 2020

Abstract

Objectives: This study explored associations between birth region, socio-demographic predictors and advance care planning (ACP) uptake.

Methods: A prospective, multi-center, cross-sectional audit study of 100 sites across eight Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital and long-term care facility (LTCF) settings. Advance care directives (ACD) completed by the person (‘person completed ACDs’) and ACP documents completed by a health professional or other person (‘health professional or someone else ACP’) were counted. Hierarchical multi-level logistic regression assessed associations with birth region.

Results: From 4187 audited records, 30.0% (1152/3839) were born outside Australia. ‘Person completed ACDs’ were less common among those born outside Australia (21.9% vs 28.9%, X2 (1, N = 3840) = 20.3, p & 0.001), while ‘health professional or someone else ACP’ was more common among those born outside Australia (46.4% vs 34.8%, X2 (1, N = 3840) = 45.5, p & 0.001). Strongest associations were found for those born in Southern Europe: ‘person completed ACD’ (OR = 0.56, 95% CI = 0.36-0.88), and ‘health professional or someone else ACP’ (OR = 1.41, 95% CI = 1.01-1.98). English-language proficiency and increased age significantly predicted both ACP outcomes.

Discussion: Region of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP.

Keywords: advance care directives, end-of-life care, cultural and linguistic diversity, autonomy, health law, advance planning

JEL Classification: K10, K30, K39, K32, I10, I18, I14

Suggested Citation

Sinclair, Craig and Sellars, Marcus and Buck, Kim and Detering, Karen and White, Ben and Nolte, Linda, Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: A Multi-Center Audit Study (August 17, 2020). Journals of Gerontology - Series B: Psychological Sciences and Social Sciences, 17.08.2020, p. 1-35., Available at SSRN: https://ssrn.com/abstract=3678356

Craig Sinclair

University of New South Wales (UNSW) - ARC Centre of Excellence in Population Ageing Research (CEPAR) ( email )

Kensington
High St
Sydney, NSW 2052
Australia

Marcus Sellars

affiliation not provided to SSRN

Kim Buck

affiliation not provided to SSRN

Karen Detering

Austin Health ( email )

145 Studley Rd
Heidelberg VIC 3084, Melbourne
Australia

Ben White (Contact Author)

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/whiteb/

Linda Nolte

Austin Health ( email )

145 Studley Rd
Heidelberg VIC 3084, Melbourne
Australia

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