An analysis of aged care provider data has called for new research into the possible “unplanned effects” of the federal government’s aged care quality indicator program.
It comes after their review found that negative clinical outcomes were rarely reported in the five clinical areas examined with the exception of polypharmacy – an area not currently included in the Commonwealth’s quality indicator scheme.
The researchers from the University of Sydney and UNSW also called for a review of aged care policy and the establishment of a “robust and comprehensive” aged care quality data system.
They cautioned that understanding the connections between clinical indicators, the care needs of a facility’s residents, and the perceptions of clients and staff is “crucial”, having demonstrated a complex relationship among these factors in their analysis.
Their study used data obtained from Moving on Audits benchmarking which were collected from 426 facilities between 2015 and 2016. It covered five commonly collected clinical indicators of care quality: falls, pressure injury, physical restraint, unplanned weight loss and polypharmacy.
“With the exception of polypharmacy, commonly collected negative clinical outcomes were rare events,” according to the findings published in the journal Australian Health Review.
“It is of note that polypharmacy is not currently included in the National Aged Care Quality Indicator Program,” they said.
The Commonwealth’s scheme, which has been rolling out since January 2016, covers three areas – pressure injury, unplanned weight loss and physical restraint. The government has said it expects the number of indicators will expand in time.
Many aged care providers already use quality indicators through commercial benchmarking companies while in Victoria a program has been in operation across state government facilities since 2006.
While the new study found low incidence rates for pressure injuries, falls, unplanned weight loss and physical restraint, it found “a very high proportion of polypharmacy” with a prevalence rate of 42 per cent. Polypharmacy was defined as residents receiving nine or more medications.
The analysis highlighted a relationship between quality indicators and residents’ care needs, with a positive association found between ACFI ratings and higher proportions of polypharmacy and unplanned weight loss.
The results also showed a positive relationship between quality indicator outcomes and consumer and staff perceptions of a facility, as gleaned from satisfaction surveys.
Currently, the government’s quality indicator program is being implemented on a voluntary basis.
However, last October the Review of National Aged Care Quality Regulatory Processes by Kate Carnell and Professor Ron Paterson recommended that all residential care services participate in the scheme.
The government’s scheme has also previously been criticised for measuring only clinical outcomes without considering psychosocial wellbeing.
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