Aged care residents are up to twice as likely to suffer from serious injuries in a for-profit home as in a government-run one, a study released on Sunday by the royal commission investigating the sector has found.
The study, described by the aged care royal commission as the most comprehensive ever undertaken, paints a grim picture of the state of private-sector aged care, revealing that government-run homes dramatically outperform those run by both for-profit operators and not-for-profit groups.
It found that, over a year, one in 15 residents in government-run aged care was sent to hospital after falling, compared with one in 8.2 not-for-profit residents and one in 8.6 for-profit residents.
One in every 61.7 residents of a government-run home suffered from pressure injuries – bed sores – bad enough to require a hospital visit, against one in 33.1 in the not-for-profit sector and one in 27.2 in the for-profit sector.
Half the government-run homes had no hospitalisations for bedsores, compared with just 19% of not-for-profits and 13% of for-profits.
The study comes after coronavirus killed almost 700 residents of aged care homes, which the royal commission has already found had not been sufficiently prepared for the pandemic by the federal government, which is responsible for regulating the sector.
In Victoria, which was hardest hit by the outbreak, more than 40% of deaths occurred in 10 homes, none of which were run by the state government.
At one home, Kalyna Care, a woman who later died of conditions unrelated to Covid-19 was left with ants crawling from her wounds, and other residents went without food after staff were stood down due to the virus.
The royal commission has also criticised the federal government for failing to properly monitor what goes on in aged care homes, saying in August that if the recommendations of previous reviews of the troubled sector had been followed, “the persistent problems in aged care would have been known much earlier and the suffering of many people could have been avoided”.
Its latest study compared care indicators, including rates of hospitalisation from injuries, across the three parts of the aged care industry.
Aged care is dominated by not-for-profits such as church groups and charities – 57% – while 34% are run by for-profit companies and just 9% are in government hands.
In homes run by the Victorian and Queensland governments, there are minimum ratios of staff to residents, but no such requirements exist in the private sector.
The study found that government homes returned the best results on 31 of the indicators. Not-for-profit homes performed best on two indicators and the for-profit sector had the best performance on just one indicator – the level of chronic opioid use by residents.
It found that in addition to being at less risk of physical injury, residents of government-run homes were also far better off when it came to mental health.
Over a year, one in 116.3 residents of a government-run home was sent to hospital with delirium or dementia. However, the hospitalisation rate for not-for-profit homes was one in 36.2 residents and in for-profit homes it was one in 33.3.
More than 80% of government-run homes had no hospitalisations for delirium or dementia against fewer than half the homes in the other two sectors.
Residents of non-government homes were also significantly likely to make multiple trips to the hospital emergency department or suffer from unexplained weight loss.
They were also more likely to make complaints about issues including healthcare, personal hygiene and the cleanliness or physical state of the home.
“The research was conducted to improve understanding of quality in the aged care system,” the commission said.
“It also demonstrates the value of making data publicly available at facility level to inform the community about aged care services, support consumer choice, encourage continuous improvement, and foster research and innovation.”