Optimising home care support: Insights from a comparative study

Professor Yun-Hee Jeon

A recent study conducted by the University of Sydney, published in the journal Age and Ageing, compared two Australian Government-funded programs aimed at supporting older individuals to live independently in their communities. The study analysed the outcomes and cost consequences of over 65s accessing Home Care Packages (HCPs) versus Veterans’ Affairs Community Nursing (VCN).

The analysis, which involved over 40,000 participants, found that within five years of accessing services, 58 per cent of HCP clients had been admitted to an aged-care home, compared to only 27 per cent of VCN clients. Additionally, the economic analyses estimated cost savings for relevant government providers over five years to be over $1 billion for VCN compared to HCP clients. Even if the cost of the VCN program increased to match that of HCP, significant cost savings would still be realized.

The VCN program, funded by the Department of Veterans Affairs, is available to Veterans Gold Card holders and some Veteran White Card holders, while HCP is open to all eligible older individuals in the community. The study underscores the importance of providing appropriate support to older individuals to delay or prevent care home admissions, which can result in higher quality of life and lower costs to the government.

Lead author Professor Yun-Hee Jeon highlighted key differences in the delivery of the VCN program, such as shorter referral times and the involvement of registered nurses in care planning. The savings largely resulted from delaying aged care home admissions, which can cost over $90k per person per year.

“The major difference is that the veterans’ program is led and mostly delivered by registered nurses, based on a care plan directly from the registered nurse’s comprehensive assessment, with a very short wait time from a referral.”

Professor Yun-Hee Jeon

The study also revealed differences in participant behaviour, with VCN clients more likely to discontinue services when not immediately needed, unlike HCP clients who tend to retain services until they enter care. This behaviour was attributed to shorter wait times for VCN services compared to HCP.

Professor Jeon highlights the importance of timely and skilled care, advocating for more emphasis on ‘health-related care’ in aged care services. She stresses the need to address profession-specific issues, such as the role of registered nurses and allied health professionals, in optimising outcomes.

While the study suggests further economic analysis is warranted, the research team is confident in their findings due to the large sample size and comprehensive analyses conducted. This research underscores the significance of timely and skilled care in supporting older individuals to live independently in their communities.

DOI: https://doi.org/10.1093/ageing/afad195

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