Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
Centre for Data Linkage, School of Population Health, Curtin University, Perth, Western Australia, Australia.
Australas J Ageing. 2023 Jun;42(2):355-364. doi: 10.1111/ajag.13165. Epub 2023 Mar 14.
To examine the relationship between structural characteristics of Australian residential aged care facilities (RACFs) and breaches of the aged care quality standards.
Facility-level analysis of audits, sanctions and non-compliance notices of all accredited Australian RACFs between 2015/16 and 2018/19. Structural factors of interest included RACF size, remoteness, ownership type and jurisdiction. Two government data sources were joined. Each outcome was analysed to calculate time trends, unadjusted rates and relative risks.
Non-compliance notices were imposed on 369 RACFs (13%) and 83 sanctions on 75 RACFs (3%). Compared with New South Wales (NSW), non-compliance notices were less likely in Victoria, Queensland and the Northern Territory (NT), more likely in South Australia (SA), and comparable in Western Australia (WA), Tasmania and the Australian Capital Territory (ACT). RACFs with more than 100 beds and RACFs located in remote and outer regional areas (vs. major cities) also increased the likelihood of non-compliance notices. Compared with NSW, sanctions were less likely in Victoria, Queensland, NT and WA and comparable in SA, Tasmania and ACT. Additionally, the likelihood of sanctions was higher for RACFs with more than 40 beds. For both non-compliance notices and sanctions, no significant relationship was found with RACF ownership type.
We partially confirmed other Australian findings about the relationship between RACF structural characteristics and regulatory sanctions and reported new findings about non-compliance notices. Routine and standardised public reporting of RACF performance is needed to build trust that Australia's latest aged care reforms have led to sustained quality improvements.
研究澳大利亚养老院(RACF)的结构特征与违反老年护理质量标准之间的关系。
对 2015/16 年至 2018/19 年期间所有经认证的澳大利亚 RACF 的审计、制裁和不合规通知进行机构层面的分析。感兴趣的结构因素包括 RACF 的规模、偏远程度、所有权类型和司法管辖区。合并了两个政府数据源。对每个结果进行分析,以计算时间趋势、未调整的比率和相对风险。
对 369 家养老院(13%)发出了不合规通知,对 75 家养老院(3%)发出了 83 项制裁。与新南威尔士州(NSW)相比,维多利亚州、昆士兰州和北领地(NT)的不合规通知较少,南澳大利亚州(SA)的不合规通知较多,西澳大利亚州(WA)、塔斯马尼亚州和澳大利亚首都领地(ACT)的不合规通知相当。拥有超过 100 张床位的 RACF 和位于偏远和外围地区(而非主要城市)的 RACF 也增加了不合规通知的可能性。与 NSW 相比,维多利亚州、昆士兰州、NT 和 WA 的制裁可能性较低,SA、塔斯马尼亚州和 ACT 的制裁可能性相当。此外,床位超过 40 张的 RACF 被制裁的可能性更高。对于不合规通知和制裁,都没有发现 RACF 所有权类型与两者之间存在显著关系。
我们部分证实了其他澳大利亚关于 RACF 结构特征与监管制裁之间关系的研究结果,并报告了关于不合规通知的新发现。需要对养老院的绩效进行例行和标准化的公开报告,以建立信任,即澳大利亚最新的老年护理改革已导致持续的质量改进。