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Pathways in aged care

The Pathways in Aged Care (PIAC) link map brings together a number of data sets—and records for more than 5 million people. It allows us to analyse how people used aged care services between July 1997 and June 2014.

5 million people have records that are available for analysis through PIAC.
2.7 million deaths can be linked to other data sets through PIAC.
11.5 million aged care service events are available for analysis with PIAC.
3.6 million users of aged care services have records that can be linked between data sets with PIAC.
2.3 million aged care assessments can be linked to other data sets through PIAC.

What is PIAC?

PIAC is a link map that allows us to connect data from different sources. Information can be brought together for each person who used one of the following aged care programs between 1 July 1997 to 30 June 2014:
  • Aged Care Assessment Program (ACAP)
  • Permanent residential aged care
  • Respite residential aged care
  • Aged care packages (Home Care Packages and its pre-2013 counterparts)
  • Home and Community Care
  • Transition Care Program

The link map also includes National Death Index data for people who died between July 1997 and September 2015. The extended timeframe ensures that the link map can be used to identify as many deaths of people who used aged care before June 2014 as possible.

PIAC has evolved over time as the collection of person-level data has been established across different aged care programs. The current link map (PIAC 2014) expands on the first ‘full’ link map (PIAC 2011). The data sources, and the linkage processes that connected them, are described in Pathways in Aged Care 2014: technical guide.

What can PIAC tell us?

PIAC can be used to examine a particular cohort and study their patterns of use in some detail. For example, the link map was used recently to study how people used aged care services before their first entry to permanent residential aged care.
  • 61,300 people entered permanent residential aged care for the first time in 2013–14.
  • Around 90% of those who entered permanent residential aged care had previously used other aged care services—in all, they had used aged care in more than 1,000 combinations (or ‘pathways’).
  • People commonly entered the aged care system through community-based aged care—for 76% of people, home support (termed Home and Community Care or HACC at the time) was the first aged care service they ever used.
  • On the other hand, only one-third (36%) of people had last used home support before entering permanent residential aged care: the last service used was most commonly respite residential care (39% of people).
1. A pie chart shows the proportion of people who first entered permanent residential aged care in 2013–14 by the programs that they had used previously. The graph shows either the first program that this cohort used, or the last program before permanent residential care. Home support was the program most commonly used first (76% of people used this program first). Respite residential care was the most commonly used just before permanent residential care (39%), followed by home support (36%).

You can read more about this in the report.

How can the PIAC link map be accessed?

The link map is a valuable tool for research. Confidentialised PIAC data can be accessed by requesting customised data.

PIAC data can also be integrated into your own data set or sets, to create an expanded linked database for your research project. Strict requirements apply for collecting and releasing linked data. The AIHW is an accredited Integrating Authority, and is able to undertake this work.

You can contact the AIHW Data Integration Services Centre by emailing [email protected] for initial advice, cost estimates and help to design your research project, as well as guidance on the ethics process.
All data linkage projects, and access to AIHW linked data, require approval from the independent AIHW Ethics Committee.

Explore more about findings from PIAC, including pathways to permanent residential aged care and program use, in the next section.