Services for older people have undergone significant changes in Australia in the last
decade. After the publication of a number of major reports1, a process of reform was
implemented to restructure aged care programs in Australia (HHCS 1991a, p.l). The
core elements of the strategy included the following:

  • Reduce the nursing home supply to 40 beds per 1,000 people aged 70 and over from 67 in 1985 (AIHW 1993, p.208).
  • Increase the hostel supply to 60 places per 1,000 people aged 70 and over from 33 in 1985(AIHW 1993, p.208). This benchmark has been revised three times and is now SO places per 1,000 people aged 70 and over. The resources thus saved were reallocated to Community Aged Care Packages (AIHW 1995, pp.200-203).
  • Expand home and community care (with as yet no specific target being set) so that a greater number of people can be maintained at home.
  • Expand the multi-disciplinarays sessment teams( Aged Care Assessment Teams) to determine eligibility for all nursing home and hostel admissions.
  • Introduce new funding strategies that take into account the dependency levels of individual residents based on the Resident Classification Instrument (RCI) for nursing homes (the S:are Aggregated Model2 )and Personal Care Assessment instrument for hostels in order to provide incentives to nursing homes and hostels to care for more dependent persons.


1For example: DCS 1986, p.1; Auditor-General's efficiency report on the Commonwealth administration of nursing home programs (ANAO 1981); report on accommodation and home care for the aged (in a home or at home) by the House of Representatives Standing Committee on Expenditure (1982); Senate Select Standing Committee report on private and hospital nursing home operation (1985); and the influential Nursing Homes and Hostel Review (DSC 1986).

2Care Aggregated Model (CAM) was introduced on 1July1988 to cover the costs associated with providing nursing and personal care services to nursing home residents. It is based on each resident's needs as classified into five categories (ANAO 1995, p.85; HSH 1995, pp.Pl-P7 to Pl-P9).