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National Strategy for an Ageing Australia: World Class Discussion Paper

This discussion paper aims to inform the community and key stakeholders about current health and aged care arrangements, identify emerging issues associated with population ageing, and discuss possible directions to enhance the capacity of the health and aged care system to respond to the needs of Australians as they age.

The World Class Care Discussion paper is available for download in PDF format:

The World Class Care Discussion paper (entire paper) (PDF 576 KB)

The World class Care Discussion paper (highlights sheet) (PDF 22 KB)

Highlights Sheet

Australia's health and aged care sector is addressing population ageing.

Most Australians prefer to remain in their own homes as they grow older. The desire to remain living at home has been reflected in the shift in the balance of care and the proportion of funding being provided to residential and community care.

As the wealth of older Australians increases, there will be increased demand for a greater range of products and services related to health and aged care, and an increasing ability to make a contribution towards these costs, either directly or through insurance.

The World Class Care Discussion Paper canvasses emerging issues and directions for the health and aged care system against the objectives of access and equity, affordability and sustainability, quality, choice, and responsiveness.

• health and aged care service providers need to listen and appropriately respond to the needs, wishes and concerns of older people;
• health and aged care services need to become more responsive to the special needs of older people from rural and remote areas, diverse cultural and linguistic backgrounds and older Aboriginal and Torres Strait Islander people;
• despite substantial growth in older age groups over the last two decades, population ageing has only contributed a minor proportion to growth in health expenditure;
• measures to achieve quality and cost-effectiveness in the health system include an emphasis on evidence-based medicine and mechanisms to ensure that the uptake of new technologies is clinically appropriate;
• support for increased choice through private health insurance and the option of long term care insurance;
• in the future, cost-effective quality care provision will require that formal services are readily available to support frail older people in retaining their independence and maintaining their health as long as possible. Flexibility and better coordination will enable the health and aged care system to respond flexibly and appropriately to the needs of older people with complex and chronic care needs.

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Facts and Figures

Most older Australians are neither frail nor in need of long term care. Around 20 per cent of people aged 70 years and over use Government-funded care services: about 8 per cent live in nursing homes and hostels; and around 12 per cent receive community care services.

There are many more women than men in the oldest age groups and more women than men live alone at older ages:

• women comprise almost 70 per cent of people aged 85 years or more;
• around 38 per cent of women and 30 per cent of men aged 80 years and over live alone.

The likelihood of needing residential care increases as people get older and is higher for women than men ? at 80 years of age, a woman has a 59 per cent probability of entering a nursing home during her remaining lifetime compared to 39 per cent for a man.

Most older Australians who need care receive some support from informal carers, that is, family, friends and neighbours. In 1998, the ABS estimated that there were 201,000 primary carers of people aged 65 years and over.

The incidence of dementia increases with age:

• about 5 per cent of people over the age of 65 years and 20 per cent of people over the age of 80 years have some form of dementia;
• as the population ages, the number of people with dementia is expected to increase from 148,000 in 1999 to 258,000 people in 2021 and 450,000 in 2041.

Depression is often under-diagnosed in older people.

A significant proportion of older Australians are from culturally and linguistically diverse backgrounds. Aboriginal and Torres Strait Islander people have poorer health status than non-indigenous Australians across all age groups.

In 1999-2000 the Commonwealth Government will spend over $5 billion on residential aged care, home and community care , respite and support for carers.

Public and private spending on health has been around 8.2 to 8.4 per cent of Gross Domestic Product from 1991-1998. Expenditure on health needs of people aged 65 years and over accounts for 24 per cent of medical services, 31 per cent of pharmaceutical services and 35 per cent of acute hospital services.
(April 2000)
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