There’s an old saying, money talks. Does that hold true for aged care? Specifically, does the quality of residential aged care vary with residents’ financial means?
The Royal Commission into Aged Care Quality and Safety this week released a 28-page research paper that explores that very question.
At first glance, it would appear that a light purse is a heavy curse.
The analysis, which drew on public submissions, focus groups and data collected from across the aged care system, examined concerns that facilities with a higher number of ‘supported’ residents – those who receive government assistance for accommodation fees – received poorer quality care.
The key differences found were:
- Care minutes. Residents in facilities with less than 30 per cent supported residents received more allied health and lifestyle care on average than facilities with 50 per cent or more supported residents. Also, residents in facilities with extra service revenue received more care time overall and for most staff types. Staff expenditure showed similar patterns.
- Assaults. The number of total assaults and serious physical assaults were higher on average in the facilities with 50 per cent or more supported residents. However, the number of sexual assaults were higher in facilities offering extra services.
- Restraints. The use of physical restraints was higher on average in facilities with 50 per cent or more supported residents. The use of physical restraints was also higher in those facilities.
- Drugs and hospital transfers. The number of chronic opioid users was higher on average in facilities with 50 per cent or more supported residents. Those facilities also had higher hospital or emergency department readmission rates for long-term residents.
Generally, the analysts found submissions were common across the sector, regardless of residents’ financial means.
By most other measures, the report says, such as dollars spent per patient, the number of staff available and consumer experience, life was similar in residential aged care regardless of a resident’s wealth. Any difference in care could be attributed to residents paying for extra services.
In the analysis, facilities were grouped according to the percentage of residents who are supported, split into four bands:
- under 30 per cent supported residents
- 30-39 per cent supported residents
- 40-49 per cent supported residents
- 50 per cent or more supported residents.
The percentage of all residents who were supported residents in the 2016/17 data averaged 38 per cent in for-profit facilities, compared to 47 per cent in not-for-profit facilities and 57 per cent in government facilities. In the 2018/19 data, the percentages of residents who were supported averaged 33 per cent in for-profit facilities, compared to 47 per cent in not-for-profit facilities and 53 per cent in government facilities.
Facilities were also split into those with and without extra service revenue. The percentage of facilities with extra service revenue was 48 per cent for those that had less than 30 per cent supported residents. This fell as the share of supported residents increased. Just 21 per cent of the facilities had extra service revenue among those with 50 per cent or more supported residents.
The final report of the Royal Commission into Aged Care Quality and Safety is due on 28 February.
Do you have experience of residential aged care? Does the report ring true for you?
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