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Financial means and quality in residential aged care

New research by the Office of the Royal Commission into Aged Care Quality and Safety investigates whether the quality of aged care facilities varies with residents’ financial means.

The research draws on public submissions, focus groups and statistical analysis of data collected from across the aged care system. The results are presented in Research Paper 19 – Does the quality of residential aged care vary with residents’ financial means?

In the public submissions, older people with lower financial means felt they had, or were perceived to have, less choice and be more at risk of financial stress when making decisions in times of crisis. But otherwise, the submissions describe issues which are common for people in the Australian aged care system, regardless of their financial means.

Focus group participants believed people with greater financial means are more easily able to find a comfortable aged care facility and a higher quality of service.

The statistical analysis examined a wide range of quality indicators across facilities based on the share of residents who are supported with their accommodation fees and whether the residents pay for extra or additional services. A small number of the quality indicators showed statistically significant differences but the large majority did not. The main statistically significant differences found were:

  • Care minutes—Residents in facilities with less than 30 per cent supported residents received more allied health and lifestyle care minutes on average than facilities with 50 per cent or more supported residents. Also, residents in facilities with extra service revenue received more care time overall and for most staff types. Staff expenditure had similar patterns. These differences might be partially or fully explained by the complexity of residents’ care needs, or the extra service fees paid by residents.
  • Assaults—The number of total assaults and serious physical assaults were higher on average in the facilities with 50 per cent or more supported residents than in those with less than per cent. However, the number of sexual assaults were higher in facilities offering extra services.
  • Mandatory indicators—The use of physical restraints was higher on average in the facilities with 50 per cent or more supported residents than in those with less than 30 per cent. The use of physical restraints was also higher in facilities without extra service revenue than in those with extra service revenue. However, facilities with extra services had higher rates of stage 1 pressure injuries.
  • Clinical indicators—The number of chronic opioid users was higher on average in facilities with 50 per cent or more supported residents than in facilities with less than 30 per cent or 30–39 per cent supported residents. Facilities with 50 per cent or more supported residents also had higher hospital or emergency department readmission rates for long-term residents.

The research paper was prepared for the information of the Royal Commissioners and the public. Any views expressed in the paper are not necessarily the views of the Commissioners.

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