In the 5 years to 2020–21, the number of people using PRAC appraised as requiring palliative care and other care has remained relatively stable, with slight fluctuations over this period (see Figure AC.3.). However, the number of new admissions each year has been falling slightly between 2017–18 and 2020–21 (from 2,700 to 2,400 for palliative care appraisals and from 69,200 to 64,800 for other appraisals).
These declines in palliative care admissions are unlikely to be due to a fall in the need for palliative care, but rather may reflect the application of the ACFI in recent years (see above and Inquiry Report, Section 3; Productivity Commission, 2017 for further details). Further, in 2020, ACFI reviews were undertaken from the Department of Health's offices since 2020 to minimise COVID-19 transmission risks (DoH 2020).
Residential aged care and COVID-19
The COVID-19 pandemic, commencing in Australia from March 2020, has had a significant impact on the aged-care sector and those receiving aged care. People living in PRAC are at an increased risk of COVID-19 due to a high proportion who are aged 70 and over (94% of people using PRAC), and/or who are immunocompromised due to conditions such as cancer and other chronic diseases (DoH 2021a).
By looking at monthly PRAC data it may provide insights on the impact of the COVID-19 pandemic on palliative care in the PRAC setting. These data highlight that there was a large drop in the number of new admissions for PRAC between March and May 2020 – 28% and 24% decline for people appraised as requiring palliative and other care, respectively – reaching its lowest level in May 2020 over the 3 year period (July 2018 to June 2021). Another dip was also observed in October 2020 and January 2021 for palliative care admissions and in August 2020 and January 2021 for other care.
These declines may in part be due to the stricter public health restrictions during these months, however fluctuations in admissions may reflect a number of factors that may or may not be related to the COVID-19 pandemic. By February 2021, number of admissions had largely recovered to similar levels observed prior to the COVID-19 pandemic in March 2020.
In terms of exits from PRAC and reasons for exit no clear patterns were observed during 2020 and 2021, with various fluctuations observed between March 2020 and June 2021.
Figure AC.3: Admissions and people using permanent residential aged care appraised as requiring palliative and other care, 2016–17 to 2020–21