The future of residential aged care in Australia; a mixed methods analysis of the relationship between policy, structure and the provision of care
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Governments, providers and consumers will make substantial investments to expand the residential aged care sector in Australia over the next decade. Australians have the right to expect that the structure (size, ownership and location of services) of the sector that emerges from this expansion will be consistent with evidence based best practice. This mixed methods study analysed secondary census data on all residential aged care services in Australia over 10 years, secondary data on sanctioned services and primary data from semi-structured interviews with elite stakeholders. The study finds that the structure of the residential aged care sector impacts quality and government policy impacts structure. It also finds that current structural trends are inconsistent with evidence based best practice and that these trends are likely to continue, particularly if market based reforms are introduced. The study also finds that market based reform will likely to fail outside major cities and a two tier system of residential aged care will be required. The study recommends a new conceptual framework for the relationship between structure, process and outcomes and that market based reforms should not be pursued until there is a national set of freely available and reliable data to inform decision makers.
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