No strong link between low financial means and quality
The perception that financial means is linked to better care is supported by some quality indicators but not the majority, research from the royal commission has found.
The perception that financial means is linked to better care is supported by some quality indicators but not the majority, research from the royal commission has found.
Indicators adding some weight to the view include assaults, care minutes and physical restraints.
The report, released by the Royal Commission into Aged Care Quality and Safety on Monday evening draws on public submissions, focus groups and statistical analysis of aged care system data based on a facility’s share of supported residents, which means the government partially or fully pays accommodation costs, and use extra paid-for services.
In public submissions, older people with low financial means identified as having less choice and being at more risk of financial stress than others, but submissions also described issues common across the aged care system regardless of financial means.
Group participants perceived people with greater financial means are able to more easily find a comfortable aged care facility with a higher quality of service, the report found.
A small number of the quality indicators show statistically significant differences such as assaults, care minutes, physical restraints, opioid use and hospital readmissions, according to the report. But the large majority including consumer experience, complaints and issues, staff expenditure, pressure injuries, unplanned weight loss, falls, and compliance do not.
Statistically significant differences
The report found in 2018-19 that total and serious physical assaults were higher on average for facilities with 50 per cent or more supported residents than those with less than 30 per cent while facilities offering extra services had higher sexual assaults on average than other facilities.
In 2018-19, facilities with less than 30 per cent of supported residents received significantly more allied health and lifestyle care on average than facilities with 50 per cent or more supported residents.
Residents in facilities with extra services received more care time and for most staff types than facilities without extra services.
However, these differences may be partially or fully explained resident need or the fees paid for extra services rather than evidence of financially disadvantaged residents receiving lower quality care, the report found.
The use of physical restraints was higher on average in facilities with 50 per cent or more supported residents than in those with less than 30 per cent and. It was also higher in facilities without extra service revenue, the report found.
Clinical indicators
Based on the ROSA indicators use data for 2016-17, the number of chronic opioid users is higher on average in facilities with 50 per cent or more supported residents than facilities with less than 30 per cent or 30-39 per cent supported residents.
The report also found that facilities with 50 per cent or more supported residents had higher emergency department readmissions for long-term residents.
Facilities not delivering extra services had lower rates of high sedative load and hospitalisations for fractures, the report found.
Call for better data
The findings are based on quality indicator data at the facility level as quality indicators are not widely available for individual residents.
“Their development would be useful to enable researchers and policy makers to continue research such as this and help ensure all residents receive a high quality of care in the future,” the report said.
Access the report here.
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