Leading aged and community care researchers have highlighted serious shortcomings in department-commissioned research into the government’s home care changes.
The Department of Health last week released the findings of an evaluation conducted by market research agency AMR of consumer and provider satisfaction with the Increasing Choice in Home Care reforms. In its release the department highlighted only positive findings, such as reporting “The wait time experienced by participants before they were assigned a package was usually seen as satisfactory (74%).”
But university researchers Community Care Review has spoken to have raised concerns about the small size and representativeness of the consumer survey sample.
Lee-Fay Low, an associate professor in ageing and health from the University of Sydney, said the sample of 215 seniors represented fewer than 1 per cent of consumers using or waiting for a home care package.
Due to the use of a telephone survey, the sample was also biased towards “higher functioning, higher educated, English-speaking consumers,” said Dr Low.
Only 5 per cent of the seniors surveyed identified as culturally and linguistically diverse. Western Australia and the Northern Territory also had limited to no representation in the sample.
Older people who might find the system more difficult to use would also be less likely to answer the survey, Dr Low said.
“Given the biased nature of the sample, and the small sample size, it’s difficult to be confident that the results reflect the experience of most older people waiting for or receiving home care packages,” Dr Low told Community Care Review.
Similarly, Dr Lyn Phillipson from the University of Wollongong said the use of repeated telephone surveys made it difficult for people with cognitive impairment or communication difficulties to participate.
Measuring consumer outcomes, not just satisfaction, was also needed in any analysis of the home care reforms, said Dr Phillipson, a NHMRC-ARC Dementia Fellow at the Australian Health Services Institute.
“We need research that can capture the voice of our most vulnerable older people to ensure their needs can be considered in the government’s assessment of the impact of these current aged care reforms.”
Older people also often tend to report feeling very grateful for services, which may also be translating into high satisfaction with services, Dr Phillipson said.
Associate Professor Briony Dow, director of the National Ageing Research Institute, said the research primarily captured the views of clients in receipt of services rather than the large number of people currently waiting in the queue.
As Community Care Review has been reporting, there are about 100,000 seniors waiting for home care at their assessed level of need.
The generalisability of the research’s findings is also limited by the small sample, the lack of representation of some home care user groups and the clients’ poor understanding of aged care programs and services, Dr Dow said.
A spokesperson for the Department of Health said the research firm AMR had advised that “the sample was large enough to enable meaningful quantitative analysis.”
Further work was currently being conducted with consumer groups where sample sizes were not large enough for analysis, such as those who have been assigned a package under the new system and with CALD and indigenous consumers, the spokesperson said.
The research findings have also highlighted the opportunity to improve the information consumers are given to help them set up services, the department said. “Work on this is currently underway.”
Elsewhere, Dr Rajna Ogrin, a senior research fellow with the Bolton Clarke Research Institute, told CCR that the increase in casual employment reported in the provider survey was concerning and the ramifications needed to be further explored.