Trends in the utilisation of aged care services in Australia, 2008-2016

Abstract

Background: Aged care support services in Australia are delivered through home care packages, permanent residential care, respite care and transition care. This study aimed to determine age and gender specific incidence rates of aged care service utilisation in Australia between 2008-09 and 2015-16. Methods: This is a population-based epidmiological study of people accessing aged care services in Australia. The trends and characteristics of people (over the age of 65 years old) accessing aged care services in Australia were evaluated, using data (2008-09 and 2015-16) from the Australian Institute of Health and Welfare and Australian Bureau of Statistics. The yearly utilisation incidence rates (per 1000 people) per service type were calculated and changes in incidence rate ratios (IRR) of service utilisation for the study period were estimated using Poisson regression models. Results: The proportion of older Australians aged ≥65 years who used aged care services remained similar between 2008-09 (5.4%, N = 208,247) and 2015-16 (5.6%, N = 248,669). However, the incidence use of specific services changed during the study period. Specifically, admissions into permanent residential care decreased (from 23.8/1000 people in 2008-09 to 19.6/1000 in 2015-16, at a IRR of 0.84/year, p < 0.001) but increased for transition care (from 4.3/1000 in 2008-09 to 6.6/1000 in 2015-16, at a IRR of 1.57/year, p < 0.001) and home care packages (from 8.04/1000 in 2008-09 to 12.0/1000 per 1000 in 2015-16, at a IRR of 1.52/year, p < 0.001). Between 2008-09 and 2015-16, the greatest changes in IRR were observed in males aged 80-89 years accessing transition care (IRR = 1.68/year, p < 0.001). A higher proportion of people aged between 80-89 years (≥45%), females (≥60%), Australia born (≥ 60%) and English speakers (≥80%) used all the service types. Conclusions: Patterns of service utilisation for aged care services changed over the study period with a decrease in incidence of individuals accessing permanent residential care but increased for other service types. This finding reflects changes in attitudes regarding ageing in place and policies. These findings are helpful to inform key stakeholders on service planning to further improve quality of the aged-care services in Australia.