Aged care 'entry period' not a measure of performance

A measure often used as a performance indicator for the residential aged care system has turned out to be unrelated to actual performance, according to a report released today by the Australian Institute of Health and Welfare.

'Entry period' is the time in days between assessment of a person by an Aged Care Assessment Team (ACAT) as being eligible for residential aged care, and entry of that person into a residential aged care service.

In 1999-00 the median entry period was 34 days, but it varied substantially between people admitted for low care (55 days) and those admitted for high care (24 days).

The report, Entry Period for Residential Care,warns that entry period is not a proxy measure of waiting time for admission to a residential aged care facility.

According to the Head of the AIHW's Welfare Division, Dr Diane Gibson, 'In recent years entry period has been increasing, and concerns have been raised that this reflects decreasing accessibility of aged care in Australia'.

'Our analyses have shown, however, that the supply of services in any particular region has a negligible effect on entry period.

'In fact one of the main determinants of a short entry period was whether the resident had an ACAT assessment performed while they were in hospital rather than when they were living at home. A longer entry period was also strongly related to whether the resident had used a community aged care package or residential respite care prior to admission.

'Many people assessed by an ACAT and recommended for residential aged care never enter a residential service. Others receive recommendations for both residential aged care and a community aged care package, and take up the latter.

'Recommendations for residential care remain active for 12 months, so people often don't have to act on the recommendation immediately. They may simply believe they are quite capable of continuing to manage at home, and do not need admission.

'Others need time to decide what they want to do. Some want to enter a particular service and are prepared to wait a lengthy period for that opportunity. For others, personal circumstances may change, either for the better or the worse, affecting the timing of their decision.

'The point is there are many factors that affect entry period, but are not actually linked with performance of the aged care system.

'On the basis of our work for this report the AIHW recommends that entry period is not used as a performance indicator.

'Waiting time in the aged care system, as opposed to entry period, is an important piece of information for which we do not yet have national statistics. Before data can be collected a definition of 'waiting time' needs to be agreed. A good starting point would be to define it as the time between a person actively seeking residential aged care and actual entry to aged care.'


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