New research presented to the Royal Commission has found that Australia remains far behind other developed nations including Sweden, Germany and the USA when it comes to monitoring and reporting on quality outcomes.

A recent Research Paper, prepared by the South Australian Health and Medical Research Institute (SAHMRI), found that Australia could immediately introduce routine monitoring and public reporting across several areas. This could likely be pulled from already existing data, meaning there would almost no additional burden to providers.

Some of these quality indicators include:

• Falls and fractures;
• Pain;
• Pressure injuries;
• Hospital readmissions;
• Hospitalisation for dementia and delirium;
• Medication administration;
• The use of care plans; and
• Weight loss and malnutrition.

Currently, the Australian Government does not have any care quality outcome reporting established for home care, and only three indicators in residential aged care. Clearly, this is far below the acceptable standard for a country with one of the highest standards of living in the world.

Both Tony Pagone QC and Ms Lynelle Briggs AO (Royal Commissioners) have stated that public reporting and an independent measurement system are critical for the proper operation of the aged care system.

“Unbiased measurement and reporting of performance is vital to create accountability and continuous improvement in the aged care sector. Without it, problems are hidden from sight and not addressed,” the Commissioners said.

“It is unacceptable that in 2020 the aged care system is still without this. Had the Australian Government acted upon previous reviews of aged care, the persistent problems in aged care would have been known much earlier and the suffering of many people could have been avoided.”

The need for aged care quality indicators was originally recommended by the Productivity Commission in its 2011 Caring for Older Australians report. This recommendation was reinforced in the 2017 Review of National Aged Care Quality Regulatory Processes. Based on the present research, the SAHMRI has further strengthened this view by suggesting that an independent body oversee quality reporting and monitoring in Australia, which would include implementing evidence-based targets and clear data custodianship. It also recommends adopting real-time data collection as part of ongoing public reporting.

The SAHMRI examined over 300 aged care quality indicators across 11 countries. These included the USA, Canada, New Zealand, the United Kingdom, the Netherlands, Denmark, Finland, Sweden, Germany and Iceland. Overall, Australia’s performance ranked on the lower end, particularly in regards to the rate of unplanned weight loss and use of medication reviews.