Aims: To examine the quality and safety of care among South Australians living in residential aged care (RAC) or receiving home care package (HCP) services in 2022-2023.
Methods: Using the Registry of Senior Australians (ROSA) Prospective Cohort, we examined the prevalence and variation of 12 risk-adjusted quality of care indicators for RAC and 15 for HCP. Individuals aged ≥65 years (or ≥50 years for Aboriginal/Torres Strait Islanders) who received RAC between 01/10/2022-30/06/2023 or HCPs between 01/07/2022-30/06/2023 and enrolled in ROSA were included. Prevalence with 95% confidence intervals [CI]) and risk-adjusted facility/service-level variation using upper and lower 95%CIs around the state average were reported.
Results: Overall, 13,583 RAC residents (median age 86; 63% women) from 236 facilities and 21,925 HCP recipients (median age 82; 64% women) from 117 services were included. The most prevalent indicators were: wait time for services (HCP only: 51.3% [95%CI 50.2-52.4]), antibiotic use (RAC: 51.1% [95%CI 50.2-51.9]; HCP: 50.2% [95%CI 49.5-50.8]), chronic disease management plan (HCP only: 48.1% [95%CI 47.4-48.7]), high sedative load (RAC: 37.9% [95%CI 37.1-38.7]; HCP: 26.9% [95%CI 26.3-27.5]), and emergency department presentation (RAC: 31.6% [95%CI 30.8-32.4]; HCP: 42.2% [95%CI 41.5-42.8]). Among 214 RAC facilities and 97 HCP services, 13.6% and 23.7%, respectively, had estimates higher than the expected range for the state for at least one indicator, while 94.4% and 79.4% had estimates below.
Conclusions: Our study highlights key areas to improve the quality of care for older South Australians accessing aged care services. Sharing best practices from high-performing providers could improve care quality.