Report shows Australia out-spent on aged care

Comparisons with international systems and innovations in aged care has identified many opportunities for improvement in Australia, according to researchers at Flinders University.

Flinders University experts from the Rehabilitation, Aged and Extended Care research group and Caring Futures Institute with research partners produced two major reports for the Royal Commission into Aged Care Quality and Safety that examine how aged care is delivered around the world and the types of innovative approaches used.

Flinders University Professor Maria Crotty, senior research fellow Dr Suzanne Dyer, and Professor Anthony Maeder were leads in the reports.

The authors point to Denmark and Sweden as countries likely to have good quality long-term care systems. Both have government expenditure on long-term care for older people greater than 4% of Gross Domestic Product (based on OECD data), whereas Australia spends around 1.2%.

Australia’s spending on long-term care is among the lowest of the countries in the study. A relatively high proportion of Australia’s long-term care recipients are in residential institutions (around 45%) while most other countries support a greater share of their long-term care recipients through home and community care.

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Staffing in Australia’s residential institutions appears at the lower end of the range internationally, both for total staffing and nursing.

Australia predominantly regulates aged care quality through a single central agency using an inspection-based approach. Many other nations have multiple levels of responsibility for regulation of quality and many have a decentralised approach.

The report notes the need to think of a care system from the social rather than just economic perspective and highlights some key areas where the authors consider that care for older Australians can be improved:

• Increasing support for home-based care and informal carers – more high-level Home Care Packages and more general leave provisions and financial assistance for informal carers.
• Increased involvement of local or regional authorities in the regulation and monitoring of long-term care services.
• Increased professionalism of the workforce, for example mandatory training or registration of care workers.
• Increased transparency in staffing levels.
• Mandatory reporting and public availability of quality of care indicators, which could include standardised assessments such as the InterRAI or Australian clinical quality registers.
• Better integration with the healthcare system to improve the management of chronic diseases including dementia.
• Stronger focus on rehabilitation and maintaining function to delay and avoid disability.
• Incorporation of principles of human rights in the aged care standards.

To read the research papers, please visit the Royal Commission publications page.

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