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Suboptimal medication-related quality of care preceding hospitalisation of older patients

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Chronic diseases are the leading cause of death and disability worldwide, and their prevalence is increasing, particularly in the older population.1 In Australia, chronic diseases account for 70% of total health expenditure, costing $91.2 billion in the 2010–11 financial year.2 Optimal management of chronic disease therefore has significant potential to reduce health care expenditure, as well as to improve health outcomes for individuals.

In Australia, it is estimated that between 2% and 3% of all hospital admissions are medication related.3 There were 9.3 million hospital separations in Australia during 2011–2012 at an average cost of $5204 per separation; this suggests that there are about 232 500 medication-related admissions per year at an annual cost of $1.2 billion.4 Many of these hospitalisations could potentially be prevented by delivery of appropriate primary care.3

To facilitate the reduction of medication-related morbidity, clinical indicators have been developed that assess processes of care associated with medication use and ensuing adverse outcomes of hospitalisation.5,6 These medication-related clinical indicator sets were originally developed more…