The corporatisation of Australian residential aged care

The challenge

In Australia, residential aged care is becoming increasingly concentrated, with a decline in the number of independent, mission-oriented homes and an expansion of homes operated by multi-site, corporatised providers. The concentration of residential places operated by large corporate entities has raised questions about residents’ quality of care. This project investigates the effects of corporate structure on quality of care by examining home acquisitions, focusing on home ownership changes between providers of differing operational scale.

Solution

The analysis is conducted using home and quality data for a large sample of Australian residential aged care homes from 2015 to 2019 sourced from the Royal Commission into Aged Care Quality and Safety. The available data contains the information needed to understand how changes in home ownership impact levels of quality care, measured by preventable hospitalisations of residents and resident complaints to the regulator while considering ownership structures (for-profit, etc.) and operational scale (number of facilities run).

Outcome and impact

The project contributes to limited evidence on the corporatisation of aged care in Australia by documenting how provider’s profit-making motives result in differences in quality outcomes delivered to care recipients. These findings hold significance across the fields of governance, corporate strategy, and policy within healthcare – with evidence to inform the practice agenda for Australia’s residential aged care sector.

The research centre is a complex, intractable, problem-solving organism. And it's really about, 'how do we enable an environmentally, socially, and economically sustainable care and support system for older Australians'.

Some of the things we've been focused on is looking at, say, workforce issues. Having enough workers in aged care and workers with the rights skills is really important. The government have been instituting mandatory staffing requirements. So, some of the work we've been doing is tracking how aged care homes across Australia actually meet those requirements or not. If there are workforce shortages, how are homes trying to meet those targets?

And we've also been tracking the up-tick in the use of external contractors or agency staff within aged care homes, which is probably concerning because we know that it's just a temporary solution. So that's just kind of one of the projects we've been working on within the workforce elements within the Centre.

We are currently going through a once-in-a-generation transformation of the aged care sector, so what we're left with after maybe the next, maybe, two or three years is what we will have for then the following two or three decades at least, and so the work we are currently doing is incredibly important.

If aged care is mainly funded right now by Australian taxpayers. And it's, as David said, it's going to grow, then this is an issue that's actually really important for all generations. Both the people who are going to use the services and the people who are going to be paying for those services for the next several decades.

It is something that we can have a material impact on and make a significant contribution to the lives of millions of people.

It's incredible, actually, to work in a domain where the work that you do has such appreciation and such impact and consequence.

Research outputs

Journal articles

Sutton N, Ma N, Yang J.S and Lin, J. (2024). Quality effects of home acquisitions in residential aged care. Australasian Journal on Ageing http://doi.org/10.1111/ajag.13268