Pathways through aged care services: a first look

AIHW bulletin No. 73, October 2009

The full report: Pathways through aged care services: a first look

Summary

Analysis of people’s use of care services over time provides information that is useful to both policy planners and service providers alike. The Pathways in Aged Care (PIAC) study linked 2003–04 Aged Care Assessment Team (ACAT) assessment data to data sets showing use of five main aged care programs and to deaths data. The resulting linked database is a rich source for examining the diversity of client pathways through the aged care system, starting from ACAT assessment.

This bulletin presents the first results from analyses using the PIAC data, concentrating on the cohort of 77,000 people who had an ACAT assessment in 2003–04 and who had not previously used aged care services that required an ACAT assessment for access. The main findings are:

• Over half of the cohort had previously used two key community care programs that did not require an ACAT assessment (Home and Community Care and Veterans’ Home Care).
• Although approval for program use from an ACAT assessment is valid for 12 months, reassessment within that period is common: nearly one-third of the cohort had a reassessment within 12 months, and half of these had no intervening program use.
• Assessments do not necessarily result in use of a program: 24% of the cohort had not accessed, or re-accessed, any aged care programs within 2 years of their first assessment. One-third of these people had died.
• For some people, ACATs were acting as a conduit for information about community care programs that did not require such an assessment for access. Around one-fifth (21%) of the cohort had such programs as their first post-assessment step.
• The use of care programs increased over time, with the move to residential care being particularly noticeable: 23% of the cohort who were still alive after 6 months were in permanent residential aged care compared with 38% after 24 months.
• Some care programs can be accessed simultaneously. Six months after assessment:
  • Nearly 8% of the cohort who were still alive were recipients of a Community Aged Care Package; of these, nearly 30% were also using services from other programs.
  • Around 40% of people who were clients of Veterans’ Home Care were also accessing services from the large Home and Community Care program.
  • 13% of those using Home and Community Care were also accessing other programs.
  • More than half of the people in residential respite care were accessing a community care program when they were at home.
• Within 2 years of assessment:
  • Around 13% of the cohort had accessed a Community Aged Care Package.
  • Just over 40% had been admitted to permanent residential care at least once.
• Slightly fewer than 30% had died—19% within the first 3 months.