Australian Institute of Health and Welfare (2022) Palliative care services in Australia, AIHW, Australian Government, accessed 21 May 2022.
Australian Institute of Health and Welfare. (2022). Palliative care services in Australia. Retrieved from https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia
Palliative care services in Australia. Australian Institute of Health and Welfare, 27 January 2022, https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia
Australian Institute of Health and Welfare. Palliative care services in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 May. 21]. Available from: https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia
Australian Institute of Health and Welfare (AIHW) 2022, Palliative care services in Australia, viewed 21 May 2022, https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia
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Note: The information released in May 2021 has been removed due to a recently identified error in the reported data. The process for identifying residents in the aged care data appraised as requiring palliative care under the Aged Care Funding Instrument (ACFI) is complex with methods evolving over time to improve accuracy in data processing. More detailed information on palliative care for people living in residential aged care will be released in May 2022.
The Australian Government subsidises residential aged care services for older Australians whose care needs are such that they can no longer remain living in their own homes. Residential aged care services provide accommodation and services to people who require full-time care, including personal and nursing care, due to chronic impairments and a reduced degree of independence in activities of daily living.
This section includes information on permanent aged care residents and new admissions who have been appraised as requiring palliative care services based on the Aged Care Funding Instrument (ACFI; see Box AC.1 for further details).
In 2019–20, there were:
Figure AC.1: Permanent residential aged care residents appraised as requiring palliative care by sex and age group, 2019-20
Vertical bar chart showing the number of permanent residents appraised as requiring palliative care, by sex and age group. Females: <65 years, 35; 65–69 years, 49; 70–74 years, 122; 75–79 years, 154; 80–84 years, 275; 85+ years, 918. Males: <65 years, 50; 65–69 years, 79; 70–74 years, 121; 75–79 years, 216; 80–84 years, 336; 85+ years, 823. Refer to Table AC.5.
The AIHW’s National Aged Care Data Clearinghouse contains data for all recipients of government-funded aged care from 1997 onwards, including prior activity data for those in care in 1997. The holdings mostly relate to government-funded aged care programs operating under the Aged Care Act 1997 and include data on Aged Care Funding Instrument (ACFI) appraisals, which are used to determine Australian Government subsidies for people living in permanent residential aged care services. These data have been used for the analyses presented here. Note that, due to COVID-19, ACFI reviews were undertaken remotely in 2020 and will continue to be conducted remotely until further notice (DoH, 2020). This may affect comparability of analyses in this and future reports with data presented previously.
Funding for palliative care under the ACFI is provided specifically for ‘end of life’ care, which takes place during the last days or week of a care recipient’s life (DoH 2016). As specified in the ACFI User Guide, funding is provided for a ‘palliative care program involving end of life care where ongoing care will involve very intensive clinical nursing and/or complex pain management in the residential care setting.’ People living in permanent residential aged care who have been appraised as requiring palliative care under the ACFI definition are included in the ‘palliative care’ group described in this section.
There are several limitations in using ACFI claims to describe palliative care need or use in residential aged care and it is accepted that the number of ACFI claims involving palliative care is inherently lower than the total number of care recipients in residential aged care requiring palliative care. ACFI is primarily focused on components of the individual’s care needs that affect the cost of care. Consequently, the capture of information on a person’s care needs, including health conditions and need for assistance with activities of daily living, may be affected by their relevance to the cost of care and the number of available fields on the form. In addition, there is little or no incentive for a service to claim for palliative care for residents who are already on the maximum ACFI Complex Health Care claim as this claim does not change the subsidy payable in this situation.
Data linkage studies have started to illustrate the difference between palliative care estimates based solely on ACFI appraisal and other (albeit limited) data sources. For example, the AIHW report Interfaces between the aged care and health systems in Australia – where do older Australians die? indicates palliative care service delivery for people living in residential aged care may be higher than that captured through ACFI appraisals, based on how many people receive some form of palliative care in their last year of life before dying in residential aged care (AIHW, 2021).
In practice, it is possible to receive palliative care in residential aged care without having received an ACFI appraisal indicating the need for end of life palliative care. Additionally, ACFI only records care required during the last days or week of a person’s life and doesn’t take into account that palliative care may be delivered and/or required for a much longer period. Also note that the data available cannot confirm the extent or nature of palliative care actually provided for those who were funded for palliative care under the ACFI.
For more information on the data used in this report, refer to the Data Sources section. For more information about the ACFI, please refer to the Department of Health website.
AIHW (Australian Institute of Health and Welfare) (2021) Interfaces between the aged care and health systems in Australia, AIHW, Australian Government, accessed 15 March 2022.
DoH (Department of Health) (2016) Aged Care Funding Instrument (ACFI) User Guide, DoH, Australian Government, accessed 15 March 2022.
DoH (2020) The Aged Care Funding Instrument (ACFI), DoH, Australian Government, accessed 15 March 2022.
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