Admissions into aged care
Australia’s aged care system offers a range of services to support people’s varying personal and health circumstances. Each year many older Australians enter or re-enter aged care or change the type of care they are receiving.
Last updated: 28 June 2023.
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Contents
Aged care admissions by age
Aged care admissions by sex
Aged care admissions by age and sex
Aged care admissions over time
Home care admissions over time
Aboriginal and Torres Strait Islander Australians admissions to aged care
Admissions for people from culturally and linguistically diverse backgrounds
States and territories
Remoteness
COVID-19 and aged care admissions
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Related information can be found on other GEN topic pages
For a confidentialised unit record file (CURF) on this topic, view the GEN data: Admissions into aged care.
The aged care system offers a continuum of care under three main types of service:
- Home support (Commonwealth Home Support Programme), which provides entry-level services focused on supporting individuals to undertake tasks of daily living to enable them to be more independent at home and in the community.
- Home care (Home Care Packages Program), which is a more structured, more comprehensive package of home-based support, provided over 4 levels.
- Residential aged care, which provides support and accommodation for people who have been assessed as needing higher levels of care than can be provided in the home, and the option for 24-hour nursing care. Residential care is provided on either a permanent, or a temporary (respite) basis.
There are also several types of flexible care available that extend across the spectrum from home support to residential aged care:
- Transition care, which provides short-term care to restore independent living after a hospital stay
- Short-term restorative care, which expands on transition care to include anyone whose capacity to live independently is at risk
- Multi-purpose services, which offer aged care alongside health services in Regional and remote areas
- Innovative Care Programme, which includes a range of programs to support flexible ways of providing care to target population groups
- National Aboriginal and Torres Strait Islander Flexible Aged Care Program, which provides culturally-appropriate aged care at home and in the community.
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Department of Veterans’ Affairs community nursing and Veterans’ Home Care services for eligible veterans and their families, which provides support to help people stay independent and in their own home.
For more information on aged care services in Australia see the Report on the Operation of the Aged Care Act, or visit the Department of Health and Aged Care website.
Aged care admissions refer to the number of entries into an aged care service over a specified period, rather than the number of people who entered the service. People are counted as an ‘admission’ to aged care when they start using a service, and are counted again if they return (excluding short periods of leave). A person’s first admission to an aged care service is counted only once, although they will have multiple first admissions should they use a range of aged care services (e.g. one first admission to home care, and one first admission to transition care).
To access aged care services, a person must undergo an assessment to determine their eligibility and what care would be best for them. For most aged care programs, a person’s access to government-subsidised aged care is determined by their assessed need, not their age.
My Aged Care is a contact centre and website which serves as the starting point to access government-subsidised aged care services. The website provides a variety of information on care types, eligibility for aged care, and services in the local area. Following an initial screening through My Aged Care, people are followed-up with either a home support assessment (conducted by Regional Assessment Services; RAS) or a comprehensive assessment (conducted by an Aged Care Assessment Team; ACAT).
In a comprehensive assessment, a member of the local ACAT assesses an individual’s physical, medical, psychological and social needs. After the assessment, the ACAT advises the person of the services that they are approved for (e.g. a Home Care Package or permanent residential aged care) and the reasons for that approval. The person can then choose to begin using an aged care service at a time that is convenient to them. A number of factors may influence this decision, for example, some people may:
- wish to remain at home for as long as possible, going into approved residential care at a later date or not at all,
- delay entry to care due to personal circumstances, such as selling their home,
- choose informal care, where family, friends or the community provide support,
- reject an offer due to the cost or location.
Aged care admissions in 2021–22
The Australian Government uses Aged Care Planning Regions (ACPRs) to plan aged care services across Australia.
In 2021–22, there were over 265,000 admissions to aged care services in Australia (over 69,000 to permanent residential care, almost 83,000 to respite residential care, over 95,000 to home care, and over 18,000 to transition care). Most of these admissions were for first admissions to the particular type of care (88% for permanent residential care, 88% for home care, 87% for transition care and 63% for respite residential care).
You can learn more about ACPRs on the Department of Health and Aged Care website.
To find detailed information on the people using aged care in different ACPRs and Primary Health Networks (PHNs), please visit the My aged care region dedicated page on GEN.
Aged care admissions by age
Although the vast majority of aged care admissions are for people aged 65 and over, admissions for younger people also occur.
Younger people under the age of 65 chiefly access aged care services due to challenges associated with accessing age-appropriate accommodation and supports in the community. The Australian Government has committed to no people under the age of 65 living in residential aged care by 2025, except in exceptional circumstances. For more information on younger people in residential aged care, see the Younger people in residential aged care dashboard.
In 2021–22:
- The largest proportion of first admissions to residential aged care were people aged 85–89 (25% of first admissions in both permanent and respite residential aged care). The most common age of first admission for home care and transition care was 80–84 (24% and 23%, respectively).
- More than half of all admissions to permanent and respite residential care were for people aged 85 and over (54% and 52% respectively). By contrast, over one third of all admissions to home care and transition care were for people aged 85 and over (36% and 37% respectively).
- Over 2,500 admissions to aged care services were for people aged under 65 (representing 1.0% of total admissions), the largest proportion of which were to home care.
Aged care admissions by sex
There are more admissions to aged care for women than men across all program types.
In 2021–22:
- Nearly 3 in 5 (59%) admissions to aged care services were for women.
- Across all types of care, the proportion of admissions by sex was very similar – approximately 60% female and 40% male.
Aged care admissions by age and sex
The age profiles of men and women entering aged care services differ. Women tend to enter aged care at a later age than men.
In 2021–22:
- Higher proportions of women entered permanent residential aged care for the first time at an older age compared with men (58% of first admissions for women were aged 85 and over, compared with 49% for men).
- For home care, women and men had a similar age distribution for first admission (64% of first admissions were for women aged under 85 and similarly were 63% for men).
Aged care admissions over time
More people are entering aged care services than they were ten years ago, which is partly a function of Australia’s growing older population (the population aged 65 and over has grown by 33% over this time)
Trends over time for the 10 years from 2012–13 to 2021–22 indicate that:
- Overall, the number of total admissions increased for home care and respite residential care (217% and 30% increases, respectively) while admissions to transition care decreased by 30%.
- Admissions to permanent residential care decreased by just over 2,000 admissions over the decade (2.9%). While the number of admissions to permanent residential care decreased among women (5.9% decrease), the number of admissions for men increased (1.7% increase).
- The number of admissions for people aged 85 and over increased for home care, respite residential care and permanent residential care (192%, 37% and 1.1% increase respectively), while admissions to transition care decreased by 24%. The percentage increase in admissions by men in this age group exceeded the percentage increase in admissions by women in this age group across all care types.
- The decrease in the number of admissions to permanent residential care may, in part, be attributed to two initiatives of the Australian Government: the first being to support older Australians to age at home as intended by the Living Better, Living Longer reforms; and the second through the initiative to reduce the number of younger people entering residential care (the number of people under the age of 65 entering permanent residential care decreased by 77% over this period). See Younger people in residential aged care.
More recent trends indicate that:
- The number of admissions to home care increased by 57% (almost 27,000 admissions) between 2018–19 and 2019–20, representing the greatest year-on-year increase in admissions for home care.
- Admissions to transition care decreased by 21% (around 4,800 admissions) between 2020–21 and 2021–22
In recent years, the number of people entering aged care services is likely to have been impacted by COVID-19. See COVID-19 and aged care admissions for further information.
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Home care admissions over time
Home care provides care to individuals based on their assessed care needs. Home care packages are available at 4 levels, from Level 1 (suitable for basic care needs) through to Level 4 (suitable for high-level care needs). In recent years, the number of people entering aged care services is likely to have been impacted by COVID-19. See COVID-19 and aged care admissions for further information.
In 2021–22:
- A quarter (25%) of home care admissions were at Level 1, over a quarter were at Level 2 and Level 3 (28% and 30%, respectively) and 16% were at Level 4.
Trends in home care admissions since 2014–15 indicate that:
- The number of admissions has increased for all home care package levels.
- Home care admissions at Level 3 increased by 80% between 2020–21 and 2021–22, while admissions at Level 1 had the most dramatic increase between 2018–19 and 2019–20 (164% increase).
Aboriginal and Torres Strait Islander Australians admissions to aged care
Aboriginal and Torres Strait Islander people face multiple health and social disadvantages. As a consequence, they are more likely to develop serious medical conditions earlier in life, and have a lower life expectancy than their non-Indigenous counterparts. You can learn more about Indigenous Australians in aged care by viewing the Aboriginal and Torres Strait Islander people dashboard, or learn about the health and welfare of Indigenous Australians on the AIHW website.
In recognition of poorer health among Aboriginal and Torres Strait Islander communities, aged care services are offered to Aboriginal and Torres Strait Islander people from age 50. In practice, Indigenous Australians may face barriers to accessing and using aged care services for complex, inter-related reasons, including remoteness, language barriers, and the effects of racism and continued socio-economic disadvantage. Delivering culturally appropriate aged care can improve access to, and the quality of, aged care for Indigenous Australians. The National Aboriginal and Torres Strait Islander Flexible Aged Care Program provides culturally appropriate care for Indigenous Australians in certain locations, mostly in rural and remote areas, that are close to their communities. Data on admissions to this program are not currently available.
In 2021–22:
- Indigenous Australians accounted for 1.7% of admissions to aged care services for which data are available (permanent residential aged care, respite residential care, home care and transition care).
- Admissions to aged care for Indigenous Australians more commonly occurred at younger ages than for non-Indigenous Australians – 16% of admissions to permanent residential aged care, 16% of admissions to respite residential care, 32% of admissions to home care and 34% of admissions to transition care were for Indigenous Australians aged under 65. In comparison, less than 1% of admissions for non-Indigenous Australians were for people aged under 65, across all care types.
Admissions for people from culturally and linguistically diverse backgrounds
Many older Australians, including those living in residential aged care, were born overseas, speak a variety of languages, may not speak English fluently or have defining religious or cultural practices. These groups of people can be referred to as culturally and linguistically diverse (CALD), although these Australians are by nature heterogeneous, and situations and needs vary greatly. CALD Australians can face barriers in engaging with aged care and the support they require. Due to data availability, this section focuses on country of birth and preferred language as measures of people’s cultural and linguistic diversity.
In 2021–22:
- Across mainstream aged care services (residential care and home care), 24% of all admissions were for people born in non-English-speaking countries. The care type with the greatest proportion of admissions by people born in non-English-speaking countries was home care (29%).
- 16% of admissions to home care and around 9% of admissions to respite residential care, permanent residential care and transition care were for people who preferred to speak a language other than English.
States and territories
The number of admissions to aged care services per 1,000 people in the target population varies across Australia’s states and territories, as does the types of care services available.
In 2021–22:
- Queensland and Victoria had the highest number of admissions to permanent residential care per 1,000 target population (23.2 and 22.9 per 1,000 of the target population, respectively).
- South Australia had the highest number of admissions to respite residential care per 1,000 target population (38 per 1,000 of the target population).
- South Australia and Northern Territory had the highest number of admissions to home care services per 1,000 target population (36.5 and 35.4 per 1,000 of the target population, respectively) – and the Australian Capital Territory had the lowest number of admissions per 1,000 target population (26.6 per 1,000 of the target population).
- Northern Territory had the highest number of admissions to transition care per 1,000 target population (13.4 per 1,000 of the target population) – double the rate in every other jurisdiction (between 5.3 and 6.8 per 1,000 of the target population).
Remoteness
In general, the proportion of admissions to aged care services for the population varies within remoteness regions and depends on the types of aged care services available. The location of services may mean that people living in remote areas need to move to less remote areas to access higher-level aged care services.
In 2021–22:
- Across most aged care services, the number of admissions per 1,000 target population tended to be highest in regional centres, large and medium rural towns (MM 2–4), with the exception of transition care where the number of admissions per 1,000 target population was highest in regional centres (MM 2) across all age-groups.
- Admissions by target population to permanent residential aged care were highest in more densely populated areas (MM 1–4) and lower for small rural towns, remote and very remote areas (MM 5–7).
- The number of admissions by target population to home care was highest in large rural towns (MM 3).
- Admissions to transition care per 1,000 target population was highest in regional centres and large rural towns (MM 2–3). Transition care was not available in small rural towns and remote areas (MM 5–7).
COVID-19 and aged care admissions
Australia has faced significant challenges during the COVID-19 pandemic. COVID-19 illness can be more serious for people who have pre-existing health conditions, including older Australians.
Most of Australia’s residential aged care homes experienced a COVID-19 outbreak during 2021–22 (2,570 facilities experienced one or more outbreaks in 2021–22). The number of people entering aged care homes may have been impacted by these outbreaks. In some cases, people may have chosen not to enter care due to the risks of virus transmission, choosing instead to seek assistance from formal community care services or to receive additional informal support from family, friends or neighbours. Additional support for in-home aged care services was provided throughout the pandemic by the Australian Government including reimbursing Home Care Package providers for the costs associated in managing outbreaks.
For further information on aged care services and the COVID-19 pandemic, see the Report on the Operation of the Aged Care Act and the COVID-19 outbreaks in Australian residential aged care facilities weekly report.