Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory
Robert Borotkanics A B E , Cassandra Rowe C , Andrew Georgiou A , Heather Douglas D , Meredith Makeham A and Johanna Westbrook AA Macquarie University, Faculty of Medicine, Australian Institute for Health Innovation, Centre for Health Systems and Safety Research, Level 6, 75 Talavera Road, NSW 2109, Australia. Email: andrew.georgiou@mq.edu.au; meredith.makeham@mq.edu.au; johanna.westbrook@mq.edu.au
B Present address: John Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
C Independent Healthcare Consultant, Sydney, NSW 2000, Australia. Email: Cassandrak@live.com.au
D Murdoch University Singapore Campus, #06-04 Kings Centre, 390 Havelock Road, Singapore 169662. Email: h.douglas@murdoch.edu.au
E Corresponding author. Email: rborotk1@jhu.edu
Australian Health Review 41(6) 613-620 https://doi.org/10.1071/AH16125
Submitted: 20 June 2016 Accepted: 7 September 2016 Published: 28 November 2016
Journal compilation © AHHA 2017 Open Access CC BY-NC-ND
Abstract
Objective Government expenditure on and the number of aged care facilities in Australia have increased consistently since 1995. As a result, a range of aged care policy changes have been implemented. Data on demographics and utilisation are important in determining the effects of policy on residential aged care services. Yet, there are surprisingly few statistical summaries in the peer-reviewed literature on the profile of Australian aged care residents or trends in service utilisation. Therefore, the aim of the present study was to characterise the demographic profile and utilisation of a large cohort of residential aged care residents, including trends over a 3-year period.
Methods We collected 3 years of data (2011–14) from 77 residential aged care facilities and assessed trends and differences across five demographic and three service utilisation variables.
Results The median age at admission over the 3-year period remained constant at 86 years. There were statistically significant decreases in separations to home (z = 2.62, P = 0.009) and a 1.35% increase in low care admissions. Widowed females made up the majority (44.75%) of permanent residents, were the oldest and had the longest lengths of stay. One-third of permanent residents had resided in aged care for 3 years or longer. Approximately 30% of residents were not born in Australia. Aboriginal residents made up less than 1% of the studied population, were younger and had shorter stays than non-Aboriginal residents.
Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services.
What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available government reports are incomplete or characterised using incomplete methods.
What does this paper add? The analyses in the present study revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. The most significant finding of the study is that one-third of permanent residents had resided in an aged care facility for ≥3 years. These findings add to the overall picture of residential aged care utilisation in Australia.
What are the implications for practitioners? The analyses outlined herein illustrate how community, health services and public health data can be utilised to inform policy, monitor progress and assess whether or not intended policy has had the desired effects on aged care services.
Additional keywords: elderly, residential aged care facilities, aged care, aged, nursing homes.
References
[1] Australian Institure of Health and Welfare. About ageing in Australia. 2016. Available at: http://www.aihw.gov.au/ageing/about/ [verified 9 June 2016].[2] World Health Organization (WHO). Good health adds life to years: global brief for World Health Day 2012. Geneva: WHO; 2012.
[3] Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiology of multimorbidity. Eur Respir J 2014; 44 1055–68.
| Ageing and the epidemiology of multimorbidity.Crossref | GoogleScholarGoogle Scholar |
[4] Phillips J, Davidson P, Jackson D, Kristjanson L, Daly J, Curran J. Residential aged care: the last frontier for palliative care. J Adv Nurs 2006; 55 416–24.
| Residential aged care: the last frontier for palliative care.Crossref | GoogleScholarGoogle Scholar |
[5] Richmond R. The changing face of the Australian population: growth in centenarians. Med J Aust 2008; 188 720–3.
[6] Quine S, Carter S. Australian baby boomers’ expectations and plans for their old age. Australas J Ageing 2006; 25 3–8.
| Australian baby boomers’ expectations and plans for their old age.Crossref | GoogleScholarGoogle Scholar |
[7] Australian Bureau of Statistics. Australia experiences lowest population growth in almost a decade. 2016. Available at: http://www.abs.gov.au/websitedbs/d3310114.nsf/home/australian+statistical+geography+standard+(asgs) [verified 9 June 2016].
[8] Australian Bureau of Statistics. Births registered, summary statistics for Australia. 2016. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/3301.0. [verified 9 June 2016].
[9] Australian Government Productivity Commission. Report on government services. Canberra: Australian Government Productivity Commission; 2015.
[10] Department of Social Services. 2012–13 Report on the operation of the Aged Care Act 1997. Canberra: Department of Social Services; 2014.
[11] Australian Government Productivity Commission. Report on government services. Canberra: Australian Government Productivity Commission; 2013.
[12] Australia Institute of Health and Welfare (AIHW). Residential aged care in Australia 2010–11: a statistical overview. Canberra: AIHW; 2012.
[13] Australian Institute of Health and Welfare. Recent reforms and initiatives in aged care. 2016. Available at: http://www.aihw.gov.au/aged-care/reforms/ [verified 9 June 2016].
[14] Department of Social Services. Ageing and aged care. What has been achieved so far. 2016. Available at: https://www.dss.gov.au/ageing-and-aged-care-aged-care-reform/what-has-been-achieved-so-far [verified 9 June 2016].
[15] Australian Government. My aged care: home care packages. 2015. Available at: http://www.myagedcare.gov.au/aged-care-services/home-care-packages [verified 9 June 2016].
[16] Andrews-Hall S, Howe A, Robinson A. The dynamics of residential aged care in Australia: 8-year trends in admission, separations and dependency. Aust Health Rev 2007; 31 611–22.
| The dynamics of residential aged care in Australia: 8-year trends in admission, separations and dependency.Crossref | GoogleScholarGoogle Scholar |
[17] Australian Bureau of Statistics. Australian Statistical Geography Standard. Available at: http://www.abs.gov.au/websitedbs/d3310114.nsf/home/australian+statistical+geography+standard+(asgs) [verified 7 October 2016].
[18] Australian Department of Health and Ageing. Aged care funding instrument (ACFI) – user guide. Canberra: Australian Department of Health and Ageing; 2013.
[19] Australian Government Productivity Commission. Report on government services. Canberra: Australian Government Productivity Commission; 2014.
[20] Chambers JM. Graphical methods for data analysis. Boston: Wadsworth International Group; 1983.
[21] Cuzick J. A Wilcoxon‐type test for trend. Stat Med 1985; 4 543–7.
| A Wilcoxon‐type test for trend.Crossref | GoogleScholarGoogle Scholar |
[22] Australian Institute of Health and Welfare. Ageing. 2016. Available at: http://www.aihw.gov.au/ageing/ [verified 9 June 2016].
[23] Broad JB, Boyd M, Kerse N, Whitehead N, Chelimo C, Lay-Yee R, von Randow M, Foster S, Connolly MJ. Residential aged care in Auckland, New Zealand 1988–2008: do real trends over time match predictions? Age Ageing 2011; 40 487–94.
| Residential aged care in Auckland, New Zealand 1988–2008: do real trends over time match predictions?Crossref | GoogleScholarGoogle Scholar |
[24] Ribbe MW, Ljunggren G, Steel K, Topinkova E, Hawes C, Ikegami N, Henrard J-C, Jonnson PV. Nursing homes in 10 nations: a comparison between countries and settings. Age Ageing 1997; 26 3–12.
| Nursing homes in 10 nations: a comparison between countries and settings.Crossref | GoogleScholarGoogle Scholar |
