Abstract

BackgroundAged care support services in Australia are delivered through home care packages, permanent residential care, respite care and transition care. This study aimed to determine age and gender specific incidence rates of aged care service utilisation in Australia between 2008-09 and 2015–16.MethodsThis is a population-based epidemiological study of people accessing aged care services in Australia. The trends and characteristics of people (over the age of 65 years old) accessing aged care services in Australia were evaluated, using data (2008–09 and 2015–16) from the Australian Institute of Health and Welfare and Australian Bureau of Statistics. The yearly utilisation incidence rates (per 1000 people) per service type were calculated and changes in incidence rate ratios (IRR) of service utilisation for the study period were estimated using Poisson regression models.ResultsThe proportion of older Australians aged ≥65 years who used aged care services remained similar between 2008-09 (5.4%, N = 208,247) and 2015–16 (5.6%, N = 248,669). However, the incidence use of specific services changed during the study period. Specifically, admissions into permanent residential care decreased (from 23.8/1000 people in 2008–09 to 19.6/1000 in 2015–16, at a IRR of 0.84/year, p < 0.001) but increased for transition care (from 4.3/1000 in 2008–09 to 6.6/1000 in 2015–16, at a IRR of 1.57/year, p < 0.001) and home care packages (from 8.04/1000 in 2008–09 to 12.0/1000 per 1000 in 2015–16, at a IRR of 1.52/year, p < 0.001). Between 2008-09 and 2015–16, the greatest changes in IRR were observed in males aged 80–89 years accessing transition care (IRR = 1.68/year, p < 0.001). A higher proportion of people aged between 80-89 years (≥45%), females (≥60%), Australia born (≥ 60%) and English speakers (≥80%) used all the service types.ConclusionsPatterns of service utilisation for aged care services changed over the study period with a decrease in incidence of individuals accessing permanent residential care but increased for other service types. This finding reflects changes in attitudes regarding ageing in place and policies. These findings are helpful to inform key stakeholders on service planning to further improve quality of the aged-care services in Australia.

Highlights

  • In common with other Organization for Economic Cooperation and Development countries, the population of Australia is progressively aging with a relatively larger proportion of its population aged 65 years or above compared to 20 years ago [1]

  • Both in 2013 and 2015, the structure of Home care packages (HCP) changed, with programmes in existence previously (Community Aged Care Packages, Extended Aged-Care at Home; and Extended Aged Care at Home-Dementia, Home and Community Care) replaced by ‘Home Care Packages Programme’ and ‘Commonwealth Home Support Programme’ respectively (Fig. 1); 2

  • The incidence rate of admissions to permanent residential aged care (PRAC) decreased from 23.8/1000 people in 2008–09 to 19.6/1000 in 2015– 16, at an adjusted incidence rate ratios (IRR) of 0.84/year (p < 0.001) over the period

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Summary

Introduction

In common with other Organization for Economic Cooperation and Development countries, the population of Australia is progressively aging with a relatively larger proportion of its population aged 65 years or above compared to 20 years ago [1]. Aged care services in Australia have been subsidised by the Federal Government since 1963 and over time. Home care packages (HCP): HCP have a focus on supporting people to remain living at home and in their own communities for as long as possible and thereby preventing premature or inappropriate admission to permanent residential aged care. Residential Aged Care (RAC): There are two types of programmes delivered through RAC services: permanent residential aged care (PRAC) and respite residential care (RRC) [5]. PRAC provides government subsidised institutional residential aged care services for those who are not coping well at home. RRC provides short-term relief or break to care recipients or their usual carers in residential care facilities from their usual arrangements. Aged care support services in Australia are delivered through home care packages, permanent residential care, respite care and transition care. This study aimed to determine age and gender specific incidence rates of aged care service utilisation in Australia between 2008-09 and 2015–16

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