Monitoring of the quality and safety of our aged care services is vital for ensuring consistent high quality long term care.<\/p>\n
However, a new study<\/a>, published in the Medical Journal of Australia, has found marked variation in care quality across Australia.<\/p>\n \u201cWe found significant variations in quality measures of long term aged care for older people in Australia, particularly with regard to waiting time for home care services, ED [emergency department] presentations, antibiotic use, high sedative load, home medicines reviews, and chronic disease management plans,\u201d the authors wrote.<\/p>\n \u201cWe also found differences in quality and variations in quality between residential and home\u2010based long term care.\u201d<\/p>\n Multiple quality indicators<\/p>\n The researchers used data from the Registry of Senior Australians<\/a> (ROSA) to analyse care quality indicators for 244\u00a0754 people who received subsidised long term care in 2019.<\/p>\n \u201cThe ROSA National Historical Cohort integrates deidentified data from national and state\u2010based aged care, health care, and social welfare datasets for older Australians who were assessed for subsidised aged care eligibility or who received aged care services during 1 January 2002 \u2013 30 June 2020 (with data updates every two years),\u201d the authors explained.<\/p>\n There were 12 quality and safety indicators of care measured for residential care (including antipsychotic use, chronic opioid use, high sedative load, antibiotic use, premature mortality) and 15 for home care packages (including hospitalisations, fractures, medication\u2010related hospitalisations, emergency department [ED] presentations, pressure injury\u2010related hospitalisations, weight loss or malnutrition\u2010related hospitalisation).<\/p>\n Eight of the indicators were monitored in all states, whereas seven were only able to be monitored in four states for which hospital use data was available.<\/p>\n High use of medications<\/p>\n The researchers found a high prevalence of medication-related indicators in aged care facilities, with 21.4% of residents receiving antipsychotic medications, 45.2% having high sedative loads, 64.5% receiving antibiotics, and 26.1% receiving opioid medications for longer periods.<\/p>\n For home care recipients, medication-related indicators also remained stable, despite reductions in opioids, antimicrobial medicines, and antipsychotics in the wider community.<\/p>\n \u201cThese changes contrast with our findings, suggesting differences in medication management and health care use between older Australians in general and those receiving residential or home\u2010based care,\u201d the authors wrote.<\/p>\n Only 3.2% of home care recipients had government\u2010subsidised home medicines reviews and 43.2% received chronic disease management plans.<\/p>\n \u201cNational variation in the use of these services was quite substantial, suggesting that a nationally consistent and systematic approach to promoting them for people with home care packages is needed,\u201d the authors wrote.<\/p>\n Reducing variation in care quality<\/p>\n There was considerable variation in care quality among residential and home care providers.<\/p>\n \u201cThe three hospitalisation\u2010related indicators with the largest proportions of outlier facilities \u2026 were ED presentations, and falls\u2010 and pressure injury\u2010related hospitalisations,\u201d the authors wrote.<\/p>\n \u201cAmong the nationally assessable indicators, variability in the use of antibiotics and antipsychotics, and in high sedative load, is concerning.\u201d<\/p>\n The authors suggest adherence to clinical care standards and clinical practice guidelines could reduce care variation and promote a higher quality of care.<\/p>\n \u201cThe marked national variations in antibiotic use, ED presentations, high sedative load, longer waiting times for home care services, home medicines reviews, and chronic disease management plans suggest these areas could benefit from targeted quality improvement strategies,\u201d the authors wrote.<\/p>\n \u201cFor antibiotic use, adherence to antimicrobial stewardship guidelines can minimise inappropriate prescribing.<\/p>\n \u201cVariation in high sedative load can be reduced by safe prescribing frameworks and adherence to appropriate psychotropic medicine use guidelines for aged care.\u201d<\/p>\n Emergency department presentations could be reduced with improved multidisciplinary services such as the 24\u2010hour on\u2010call services recommended by the Royal Commission into Aged Care Quality and Safety<\/a>, while the new Support at Home<\/a> program could improve access to allied health and restorative care in the home.<\/p>\n \u201cOur findings highlight national performance on key quality measures, and we have identified areas of long term aged care that could particularly benefit from targeted quality improvement strategies,\u201d the authors concluded.<\/p>\n Read the research<\/a> in the Medical Journal of Australia.<\/p>\n![\"Aged](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/08\/shutterstock_2491352971-1-1024x683.jpg\")
The researchers found a high prevalence of medication-related indicators in aged care facilities (PeopleImages.com \u2013 Yuri A \/ Shutterstock).<\/p>\n