8: Collection and reporting of dementia and other health conditions in aged care data

There are 3 main activities proposed to improve the collection and reporting of dementia and other health conditions in aged care data. These include activities to: 

These activities may involve single projects, or multiple projects to enable monitoring of trends over time, incorporate improvements in data or to focus on a specific population group. Each activity provides information on the intended outcome, level of investment required, timeframe for completion of the activity and who is responsible for undertaking the activity. 

Activities aimed at improving dementia data through increased national data linkages and ensuring data are collected in a consistent manner in different national data sets would also improve data on people with dementia using aged care. See Dementia prevalence and incidence and Dementia type for additional activities.

As described in Enablers to support success of this plan a broad program of work is underway to improve the quality, coverage and availability of aged care data. This includes government actions in responses to the Royal Commission into Aged Care Quality and Safety, the Aged Care Data and Digital Strategy 2024–2029, the Aged Care National Minimum Data Set (NMDS), the Aged Care National Best Practice Data Set (NBPDS) and the National Aged Care Data Asset. For more on AIHW’s aged care data improvement activities, see Data improvements (AIHW 2025).

Activity 8a: Create guidelines for collecting dementia data in aged care assessments and include training information on dementia data collection in assessor training

Health condition data are collected by different people for different purposes, and most assessors and data collectors do not have clinical coding experience and require training specific to the health conditions and the electronic record systems they are using. 

The creation of guidelines for collecting dementia data in aged care assessments would include guidance on what data to collect and how to enter the data. Specific dementia data training information would be developed to incorporate into current assessor training to ensure that the data collection is fit for aged care services and ongoing dementia monitoring, following the data collection and use principle of ‘collect once, use multiple times’. This work would involve collaborating with the current assessor trainers to incorporate a dementia flag entry into an intuitive workflow to maximise capture of this data element. These guidelines could be complemented by training developed by training organisations or government agencies promoting the collection of quality systematic electronic data, such as the Australian Digital Health Agency that currently provides free online training to multiple sectors including the aged care sector. 

OutcomeDementia data collected systematically in aged care assessments
Level of investmentMedium
TimeframeShort: This would need to be prioritised as the IAT and AN-ACC are already in use.
Responsible stakeholderDepartment of Health, Disability and Ageing 
ProgressInternal departmental consultations are occurring to inform future updates of the IAT.

Activity 8b: Incorporate dementia diagnosis information in national aged care data collections

The loss of health condition information from permanent residential aged care data mean that people with health conditions, including dementia, will no longer be identified in residential aged care data alone. This will temporarily cease national reporting of many chronic conditions (including dementia) and will impact the data available in the aged care system and limit the number of people being identified with chronic diseases (including dementia) in enduring linked data assets. 

Currently, an assessor for the AN-ACC funding model can flag in the assessment whether a person has dementia, but this is not mandatory to collect and is not provided to national aged care data collections, such as the National Aged Care Data Clearinghouse (NACDC). This activity would be a high priority pilot project that involves establishing standard data collection and ICT processes to support the supply of dementia information alongside already supplied data to national aged care data collections. This allows for routine monitoring of dementia among people receiving government-subsidised aged care to recommence and would assist in identifying people with dementia in enduring linked data sets. This activity could provide a pathway to expand to other chronic conditions once mechanisms for reporting are established. 

OutcomeDementia data collected systematically in national aged care data collections
Level of investmentLow
TimeframeMedium
Responsible stakeholderDepartment of Health, Disability and Ageing; AIHW
Progress

The NCMD is working with the AIHW Aged Care Data Improvement Unit and the Department of Health, Disability and Ageing to review and consider improvements to health condition (including dementia) data collection in aged care, in line with the Aged Care NDMS, the Aged Care NBPDS and Dementia NPBDS specifications.

The NCMD is also exploring options such as the work outlined in activity 8c.

Following this activity, options for improved dementia data collection should also be explored as a dementia flag alone would not specify how diagnosis information was collected (whether it is resident/carer reported, assessor reported and/or based on medical records), or type of dementia (aligned with ICD codes), or date of diagnosis. Options for collecting data on behaviour support plans for people with dementia in residential aged care should also be explored. These plans are now mandatory for people in residential aged care who require or may require the use of restrictive practices as part of their care. Any future aged care data developments should align with the Aged Care Data and Digital Strategy, Aged Care NMDS and the Aged Care NBPDS. Planned developments should involve consultation with AIHW and other key stakeholders on how potential changes may impact aged care data, monitoring and reporting.

Activity 8c: Develop dementia identifiers and incorporate into existing data sets

This activity involves the creation of dementia flags from existing data that identify a person with dementia for use in data that do not have diagnosis information. This activity would be an interim approach until national enduring data linkages have expanded to include a greater number of data sets. 

This approach could explore linking dementia flags derived from the National Hospital Morbidity Database (NHMD) and the NACDC to the ABS Person Level Integrated Data Asset (PLIDA) using the AIHW-ABS interoperable spine. These are currently some of the most reliable sources of diagnostic information for these conditions, and together with Pharmaceutical Benefits Schedule (PBS), mortality, Survey of Disability, Ageing and Carers, and 2021 Census data, have the potential to improve the coverage of people with dementia in the PLIDA. 

The creation of flags could also be accompanied by the development of business rules, specifications or detailed code for an aged care derived dementia flag. This methodology could then be applied more broadly to linked assets to improve dementia identification. 

OutcomeIncreased identification of dementia in data assets to provide greater coverage and insights into prevalence and impacts of dementia
Level of investmentMedium
TimeframeShort–medium
Responsible stakeholderAIHW NCMD
Progress

The NCMD is progressing a project that has linked dementia flags from hospital and aged care data into PLIDA to assesses the self-reported dementia data collected from the 2021 Census (activity 3d). This work will provide insights into methods for dementia identification using linked data.

The NCMD is also examining the feasibility of a statistical-based proxy for dementia identification in residential aged care using Australian National Aged Care Classification data linked to other data in the National Health Data Hub.