Is Australia over‐reliant on residential aged care to support our older population?

In reply: We welcome the discussion of the international comparisons of the Australian aged care system by Gibson — an issue that warrants considerable attention. It is complex to get an accurate picture of Australia’s aged care system in comparison to other nations. Data published by the Organisation for Economic Co‐operation and Development (OECD) are constrained by the data provided, but were used in our research conducted for the Royal Commission into Aged Care Quality and Safety as a broad indicator for the purpose of such comparisons.1

We agree the data from the Australian Institute of Health and Welfare GEN Aged Care database reported by Gibson provides a more accurate estimate of the point‐in‐time proportion of people using residential aged care in Australia. However, it is difficult to determine the time period covered by the data reported to the OECD by many other nations; this information is unclear or completely absent for some countries in the OECD data definitions.2 We also agree there are limitations in comparisons using the OECD data.3 It is not entirely clear that all countries in the OECD dataset reported data on the basis of the same definition of institutional care. For example, it is not clear whether “skilled nursing facilities” in the United States are included in the data, and the distinction between institutional care and community‐based care in Japan may be less clear than in other nations.4 Furthermore, Japan and Switzerland provide some long term care in hospitals (which is not included in the OECD institutional care data),2 and the distribution of services between aged, health and social care systems and the private and public sectors varies in different countries. Another important factor is that these data do not take account of differences in the dependency levels of the population by age between nations.

We consider the data provided by Gibson are consistent with our conclusion that Australia is a relatively high user of residential care for the aged care population. The limitations in these OECD data highlight the need for improved collection and reporting of data on aged care to better enable transparency, benchmarking and international comparisons.