Since the 1990s, there have been changes in the focus and provision of aged care services. Of interest to policy planners and service providers is whether these changes have affected the way that people use care programs to meet their needs. This report investigates such questions using the extended Pathways in Aged Care (PIAC) database. This database, developed by the Australian Institute of Health and Welfare (AIHW), covers aged care assessments and use of 7 aged care service programs from 1 July 2002 to 30 June 2011, as well as deaths. It allows for person-based analyses. Programs included in the database are: residential aged care (RAC), aged care package programs, the Transition Care Program (TCP), Home and Community Care (HACC), Veterans' Home Care (VHC) and the Aged Care Assessment Program (ACAP).

The report examines the use of aged care programs by people aged 65 and over between 2002-03 and 2010-11.

People using services

  • Over the study period, the number of people aged 65 and over using aged care non-assessment services in a year increased by more than one-third, from 642,000 to 874,000.
  • The growth in client numbers was greater than the growth in the population aged 65 and over and did not result just from relative increases in the numbers of very old people. Much of the increase was due to greater use of community care programs.
  • On an exemplar day, over the study period between 1 in 6 and 1 in 5 people were using aged care services. Around 5% of the population aged 65 and over were in permanent RAC.
  • Among people aged 85 and over, on 30 September 2010, 58% were accessing care services. Almost one-quarter of this very old age group were in permanent RAC.

Programs used

  • Over the study period, the proportion of people using an aged care service in the 12 months before admission into permanent RAC increased. In particular, the use of community care in conjunction with respite RAC and/or transition care before admission into permanent RAC increased, while use of just community care decreased.
  • The use of aged care services before dying is increasing. Seventy per cent of people who died in 2003-04 used a service in their last year of life, compared with almost 75% in 2010-11. In
  • 2010-11, just over two-thirds of the women and half of the men aged 85 and over who died used permanent RAC in their last year of life.

Take-up of care after assessment

  • Approvals obtained through ACAP are required to access RAC, care packages and TCP. However, due to a variety of factors, an approval to use a program does not mean that the service will be used. For example, 49% of the people with an approval for permanent RAC from their first ACAP assessment in 2009-10 used such care in the next 12 months.
  • Nearly 1 in 6 people do not get an approval to use any of RAC, a care package or TCP at their first assessment under ACAP. However, these people may still access HACC or VHC. Two-fifths of assessed people without an approval from their first assessment in 2009-10 used HACC or VHC within 12 months.
  • Program use within 12 months of an initial assessment varies with a client's age, sex, carer status, housing tenure and health status.