Historical Trends and Future Projections of Demand for Permanent Residential Aged Care for Older People in Australia, 2008-2052

Ling W Davies; Tracy Air; Robert N Jorissen; Murthy N Mittinty; Gillian Caughey; Steve Wesselingh; Maria C Inacio

doi:10.1016/j.jamda.2023.09.014

Historical Trends and Future Projections of Demand for Permanent Residential Aged Care for Older People in Australia, 2008-2052

J Am Med Dir Assoc. 2024 Feb;25(2):252-258.e8. doi: 10.1016/j.jamda.2023.09.014. Epub 2023 Oct 25.

Authors

Ling W Davies¹, Tracy Air², Robert N Jorissen², Murthy N Mittinty³, Gillian Caughey⁴, Steve Wesselingh⁵, Maria C Inacio⁶

Affiliations

¹ Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA, Australia. Electronic address: Lingwen.Davies@sahmri.com.
² Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
³ Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁴ Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA, Australia; UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia; Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
⁵ South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
⁶ Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, SA, Australia; UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.

PMID: 37898162
DOI: 10.1016/j.jamda.2023.09.014

Abstract

Objectives: To examine the historical trends and predict the future rates and total volumes of permanent residential aged care (PRAC) service utilization in Australia.

Design: A population-based repeated cross-sectional and projection study of non-indigenous older people (≥65 years) accessing PRAC in Australia was conducted.

Setting and participants: Publicly available aged care admissions from the Australian Institute of Health and Welfare and population estimates from the Australian Bureau of Statistics were used.

Methods: Historical incidence rates (per 1000 people), incidence rate ratios (IRRs) and 95% CIs of PRAC admission from 2008-2009 to 2020-2021 were estimated using negative binomial regression models. The future incidence and prediction intervals (PIs) of PRAC admission between 2021-2022 and 2051-2052 were projected using a generalized additive model-negative binomial regression. All estimates were adjusted or standardized by sex and age.

Results: Between 2008-2009 and 2020-2021, the adjusted admission to PRAC decreased (from 23.6/1000 people to 15.7/1000 people with an IRR = 0.97/year, 95% CI 0.97-0.98). The projected PRAC admission rate will decrease to 12.1/1000 (95%PI 10.8-13.3) by 2037-2038 and 9.0/1000 (95%PI 7.6-10.4) by 2051-2052. The projected volume of PRAC admission will be 73,988 (95%PI 65,960-81,425) at its highest point in 2037-2038 and 64,579 (95%PI 54,258-74,543) in 2051-2052.

Conclusions and implications: The utilization of PRAC has decreased in the past decade, and a predicted decrease in PRAC use in future years is estimated. However, the volume of PRAC utilization will still increase for the next 15 years (until 2037-2038) due to our increasingly older population. These findings can inform service planning of PRAC access in Australia.

Keywords: Aged care; long-term care; projection; utilization rate.

MeSH terms

Aged
Australia / epidemiology
Cross-Sectional Studies
Forecasting
Hospitalization*
Humans
Models, Statistical*