Increased investment across the aged care sector, but particularly in home and community-based care, is needed to reduce the number and proportion of older Australians living in residential aged care, says a new report.
In the Medical Journal of Australia research article, aged care experts including Flinders University Senior Research Fellow Dr Suzanne Dyer shows Australia is a comparatively high user of residential aged care with a relatively low financial investment in the whole aged-care sector according to Organisation for Economic Co-operation and Development data.
The report summarise a review of international approaches to the provision of aged care conducted for the Royal Commission into Aged Care Quality and Safety.
Researchers used OECD data collected in 13 countries selected based on the availability of information, applicability to the Australian aged care system, and to ensure a diverse range of countries were represented.
"Long term care is the provision of services for medical needs, personal care and assistance in living independently for people with long term dependencies due to their health care needs," said Dr Dyer and colleagues in a Perspective article in the journal.
"Long term care can be provided in institutions (e.g. nursing homes or residential aged care facilities) or by providing services to assist people to remain living in their own homes, including community services such as respite care.
"Australia provides institutional long term care for almost 20 per cent of the population aged (80 years and older), and 6 per cent of those aged (65 years and older).
"This places Australia as the nation with the highest proportion of older people living in institutional care compared with 11 other nations.
"The relative use of institutional care, as opposed to home or community care, was also highest for Australia, with 52.5 per cent of long term care recipients aged 65 years and older, and 58.6 per cent of long term care recipients aged 80 years and older in institutional care."
In terms of financial investment, the authors estimated gross domestic product (GDP) expenditure on long term care for older people comprising the health component of government/compulsory long term care expenditure (not age-specific) plus social expenditure on old age benefits in kind, as reported to the OECD.
"The expenditure estimates indicate that many other nations spend a much greater proportion of their GDP on long term care for older people," they said.
"The data indicates that in Australia a comparatively high proportion of older people live in institutions, with a relatively low financial investment in the whole aged care sector."
Australia's waiting list for home care packages is likely to have an impact on the proportion of people in residential care, researchers add.
"While many countries have wait lists for home care services, the wait times of over 12 months for home care packages at the approved level (for level 2 and above; i.e., beyond basic care needs, providing low to high level care) may lead to premature admission to institutional care for some people."