RUCS shares preliminary findings

Early results of the national study looking at the drivers of residential aged care costs support the view that costs are driven by care burden rather than medical diagnoses, the lead researcher tells Australian Ageing Agenda.

The government-commissioned Resource Utilisation and Classification Study is being undertaken by the Australian Health Services Research Institute at the University of Wollongong as part of its work to investigate alternative approaches for residential aged care funding after its previous study found that the current Aged Care Funding Instrument was no longer fit for purpose.

Through a now four-part study, RUCS aims to identify the drivers of residential aged care costs, distinguish between care costs for all and individual residents and develop and test a blended funding model made up of fixed and variable components.

Preliminary findings of study one were presented to stakeholders by AHSRI director Professor Kathy Eagar at a forum in Canberra in June, however they were only made public by the government last week.

Study one involved approximately 2,000 residents from 30 aged care facilities in Melbourne, North Queensland and the Hunter region of NSW, who were assessed by an independent assessor using a tool developed for the study to understand their general care needs and whether they required nurse-led support such as catheter care, enteral feeding or daily injections.

Co-lead researcher Dr Robert Gordon said the preliminary analysis supports the belief that costs are driven by care burden associated with end of life needs, frailty, functional decline, cognition, behaviour and technical nursing needs rather than medical diagnoses.

“About 40 per cent of staff time reported is individual time with the remaining 60 per cent being shared time, supporting the concept of a fixed and variable payment model,” Dr Gordon told AAA.

The study also found that “external assessments can be effectively undertaken by qualified staff with appropriate training,” said Dr Gordon, deputy director of the AHSRI.

Specifically, assessments can be conducted by registered nurses but not enrolled nurses, it found.

The time taken to carry out the assessments ranged from less than 15 minutes (2 per cent of cases) to two hours or more (4 per cent). However, the majority of assessments (68 per cent) took between 30 minutes and one hour to complete, according to AHSRI’s update.

RUCS originally included three studies but a fourth, the Supplementary Reassessment Study, was added in June this year to re-assess how approximately half of the 2,000 residents from study one has changed.

“The supplementary study will provide critical information to inform the development of reassessment protocols associated with the outcomes of the RUCS,” Dr Gordon said.

Regarding the progress of the other studies, Dr Gordon said most of the 110 facilities recruited for study two, which aims to identify characteristics of facilities that result in different levels of fixed costs, have provided their finance data for cost analysis.

The recruitment of 80 facilities to participate in study three is underway with data collection due to commence in late September.

This study will test the casemix classification and proposed fixed and variable funding model developed in study one and study two in a nationally representative sample of services to assess the likely impact of the model for both government and providers, Dr Gordon said.

When asked to comment on the preliminary findings, Minister for Aged Care Ken Wyatt said the final report from the study will inform future decision making for aged care funding.

RUCS is expected to report to government by the end of the year.

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