Australia far behind in monitoring aged care quality

New research shows Australia could immediately establish independent, transparent, routine monitoring and public reporting of many aspects of aged care quality outcomes similar to leading countries like Denmark, Sweden, Germany, the Netherlands, and the USA. Currently the Australian Government has no care quality outcome reporting for home care and reports on only three indicators for residential care.

The research, which was performed by the South Australian Health and Medical Research Institute (SAHMRI), shows a large range of quality outcome indicators can be produced from existing data without any burden to aged care providers. This includes indicators for medication-related quality of care, falls and fractures, hospital re-admissions, hospitalisation for dementia/delirium, pain, premature mortality, pressure injury, utilisation of care plans and medication reviews, and weight loss/malnutrition.

The SAHMRI research was conducted for the Royal Commission into Aged Care Quality and Safety. The findings are presented in Research Paper 8 – International and National Quality and Safety Indicators for Aged Care which is available on the Royal Commission’s website.

The Royal Commissioners, the Honourable Tony Pagone QC and Ms Lynelle Briggs AO, say independent measurement and public reporting is essential for the good operation of the aged care system.

“Unbiased measurement and reporting of performance is vital to create accountability and continuous improvement in the aged care sector. Without it, problems are hidden from sight and not addressed,” the Commissioners said.

“It is unacceptable that in 2020 the aged care system is still without this. Had the Australian Government acted upon previous reviews of aged care, the persistent problems in aged care would have been known much earlier and the suffering of many people could have been avoided.”

In 2011, the Productivity Commission’s Caring for Older Australians report recommended that aged care quality indicators be established and published at the service provider level to enhance transparency and accountability. In 2017, the recommendation was echoed in the Review of National Aged Care Quality Regulatory Processes by Kate Carnell AO and Professor Ron Paterson ONZM.

The new research from SAHMRI examines practices in 11 countries and 305 care quality indicators. In addition to Australia, the countries were New Zealand, the USA, Canada, the United Kingdom, the Netherlands, Germany, Denmark, Finland, Sweden, and Iceland. Based on this research, SAHMRI suggests an independent body oversee quality monitoring and reporting in Australia, including data custodianship and establishing evidence based targets. SAHMRI suggests real-time data collection should be standard with routine public reporting.

In the research, SAHMRI also shows how Australia’s performance compares to other countries on various indicators. For example, the rate of significant unplanned weight loss in Australia was on the lower end of performance compared to Canada, the USA and New Zealand. Utilisation of medication reviews was considerably lower in Australia than Sweden.

The research paper was prepared for the information of the Royal Commission and the public. Any views expressed in it are not necessarily the views of the Commissioners.

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