The Australian Institute of Health and Welfare (AIHW) is an independent corporate Commonwealth entity that produces authoritative statistics to support policy and service delivery decisions, leading to better health and wellbeing for all Australians.

The Institute also provides information-development services to enable nationally consistent data. As an Accredited Data Services Provider under the DATA Scheme, the Institute links data from various sources. To do this, the Institute collaborates with governments, researchers, advisory committees and peak bodies.

The AIHW’s work in aged care and dementia includes monitoring activities through the GEN Aged Care Data website and Dementia in Australia report, analytical projects to inform planning and policy, and data improvement activities.

SYMPOSIUM PURPOSE
To demonstrate how:
• administrative data is used in research, policy and practice in aged and dementia care
• targeted activities can drive data improvements.

OVERVIEW
1. Guide to data available for aged care and dementia research, including administrative data and linked data assets.
2. Showcase of analytical projects:
-a. Mental health and suicide in aged care
-b. Aged care workforce survey findings
-c. People living with dementia using linked data
3. AIHW’s work in response to the Royal Commission into Aged Care Quality and Safety, to improve aged care and dementia data and monitoring.

LEARNING OUTCOMES
Understanding of:
• administrative data, including linked data
• how administrative data enables a person-centred view of pathways, risks and outcomes in aged care
• how data standards are critical to improving data quality, and could inform the audience’s work.

Reliable, accessible and comprehensive data is central to improving the operation and performance of Australia’s aged care and health systems, and better understanding the experiences, pathways and outcomes of those receiving aged and dementia care.

The AIHW is an independent corporate Commonwealth entity that collects, manages, analyses, improves and makes available a range of administrative data on aged care and dementia for these purposes.

The aim of this presentation is to provide a practical guide to the ‘who’, ‘what’, and ‘where’ of key datasets held and used by the AIHW, and ‘how’ researchers, policymakers and the wider community can access these data.

An update on the types and availability of the following data sources managed by the AIHW will be provided, including:
- National Aged Care Data Clearinghouse, an independent and central repository of national aged care data, accessible to the public via the GEN Aged Care Data website and through customised requests;
- National Aged Care Data Asset, National Health Data Hub, and other AIHW linked data assets that bring together information on aged care, health and other settings for analysis by researchers; and
- Data sources used to monitor and report on national dementia statistics.

An overview of how these data sources are used by AIHW in their aged care and dementia analytical programs will be discussed, and clear steps and further information on how to access these important national resources provided.

While older adults tend to report better mental health compared to working age and younger adults, people accessing aged care services may be at higher risk for poorer mental health. This study examined the frequency of mental health conditions and deaths by suicide in people using aged care services in Australia.

The AIHW Pathways in Aged Care dataset brings together de-identified individual-level information on aged care service use and assessments in Australia. This study included people who accessed home care packages and/or permanent residential care between July 2017 and June 2022. Indicators of mental wellbeing were sourced from aged care assessment data and cause of death information was extracted from the National Death Index.

The proportion of people with at least one mental health condition recorded in an assessment was highest in permanent residential care (58%) compared to home care (23%). Women were more likely than men to have a mental health condition recorded, and the frequency of mental health conditions decreased with increasing age. The average yearly age-standardised suicide rate was higher among home care package recipients compared to people living in permanent residential aged care (22.5 and 13.0 deaths per 100,000 care recipients respectively). Male aged care users were more likely to die by suicide than women.

People accessing aged care services commonly experience mental illbeing, but limited data is available to monitor their needs. Improved screening and routine monitoring of aged care recipients’ mental health and mental health service use should be prioritised, particularly for at-risk populations.

Background: The Australian Government accepted the recommendations made by the 2021 Royal Commission into Aged Care Quality and Safety involving capturing comprehensive and accurate information on the aged care workforce. The 2022-23 Aged Care Workforce Provider Survey (the Survey) was commissioned by the Australian Government Department of Health and Aged Care to capture information about the size and attributes of the aged care workforce. The Survey follows five previous survey reports and provides benchmark data to inform workforce planning, modelling, and the development and evaluation of workforce policy decisions.

Objectives: This presentation will present the key findings of the Survey including an overview of the size of the direct aged care workforce in residential and community aged care settings, and the attributes and skills of the workforce central to the delivery of quality services. Workforce characteristics presented will include occupation and employment types, age and gender distribution, residency and visa status, and skills, qualifications and training. Service or facility characteristics presented will include recruitment challenges, employment conditions and wages, and volunteer support. Findings will be compared to the 2020 Census where applicable and methodological limitations of the data discussed.

Outcomes: Since the last report published in 2020, the aged care sector has been impacted by various policy, economic and environmental changes. This presentation will be of relevance to service providers, policy-makers and researchers interested in the investigation of recent trends that are essential to securing and supporting the future workforce, and the challenges involved in collecting comprehensive workforce data.

People living with dementia have increasing care needs as their condition progresses and tend to be high users of health and aged care. Linked administrative data provide an opportunity to better understand their experiences, pathways and outcomes, and to evaluate areas of unmet need.

This presentation describes a new method for identifying people with dementia using linked data in the National Health Data Hub. In a series of studies, health and aged care service use was analysed over time, during transitions of care and across geographical regions.

Exploring transitions of care, around 1 in 4 people (23%) living with dementia in the community moved into residential aged care within 7 days of a hospital stay. This group spent 20 days longer in hospital than other older people. People living in residential aged care were less likely than those in the community to return to hospital during the following year.

Looking across geographical regions, people living with dementia outside major cities were less likely to see a specialist (45% of people in remote areas, 68% in major cities) and were less likely to be dispensed dementia-specific medicines (23% in remote areas, 39% in major cities). Use of residential respite care was low overall (5.4%) but highest in inner regional areas (6.2%).

Future work will build on these opportunities to use linked data to monitor the experiences and outcomes of people living with dementia across Australia, inform planning and identify points along care pathways that potentially need improving.

The Royal Commission into Aged Care Quality and Safety made recommendations related to improving the quality, coverage, and availability of aged care data. The Department of Health and Aged Care and AIHW have partnered to develop an Aged Care Data and Digital Strategy, Aged Care National Minimum Data Set, Aged Care Data Asset, and the National Dementia Data Improvement Plan.

The AIHW has a long-standing role in aged care data and dementia information. The aim of this presentation is to outline the importance of aged care data standards to improve data quality, address gaps and provide more opportunities for data use and reuse in understanding care for older Australians, with a specific focus on dementia.

The development of an Aged Care National Minimum Dataset (NMDS) specification aims to improve consistency of data captured across the aged care sector by applying content standards to a core set of information. The NMDS sets out what information to collect and how to record that information. The AIHW has released a NMDS V.1 and is working on a NMDS V.2 along with national best practice guidelines for data items.

Dementia is a substantial health, aged care and societal challenge. A 10-year National Dementia Data Improvement Plan released in 2023 outlines activities to improve national data to monitor dementia and provide an evidence base for policy development, service provision and planning.

Improvement of aged care and dementia data will allow us to better understand ageing and improve the lives of older people in Australia.