572 Australian Health Review November 2009 Vol 33 No 4
Models of Care
Aust Health Rev ISSN: 0156-5788 11
November 2009 33 4 572-582
©Aust Health Rev 2009 www.aushealthre-
view.com.au
Models of Care
Abstract
Introduction: The purpose of this study was to
describe the distribution of hospital and aged care
services for older people, with a particular focus
on transition care places, across Australia and to
determine the relationships between the provision
of these services.
Methods: Aggregation of health and aged care
service indicators by Aged Care Assessment
Team (ACAT) region including: public and private
acute and subacute (rehabilitation and geriatric
evaluation and management) hospital beds, flexi-
ble and mainstream aged care places as at 30
June 2006.
Results: There was marked variation in the
distribution of acute and subacute hospital beds
among the 79 ACAT regions. Aged care places
were more evenly distributed. However, the distri-
bution of transition care places was uneven. Rural
areas had poorer provision of all beds. There was
no evidence of coordination in the allocation of
hospital and aged care services between the
Commonwealth and state/territory governments.
There was a weak relationship between the allo-
cation of transition care places and the distribution
of health and aged care services.
Discussion: Overall, the distribution of services
available to older persons is uneven across Aus-
tralia. While the Transition Care Program is flexible
and is providing rural communities with access to
rehabilitation, it will not be adequate to address
the increasing needs associated with the ageing
of the Australian population. An integrated
national plan for aged care and rehabilitation
Aust Health Rev 2009: 33(4): 572–582
services should be considered.
OLDER AUSTRALIANS are significant users of hos-
pital and aged care services.
1
Resources servicing
the needs of older people include hospitals which
provide acute services, subacute services that
Lynne C Giles, PhD, Senior Research Fellow
Julie A Halbert, PhD, Senior Research Fellow
Maria Crotty, BMed, PhD, FAFRM(RACP), Professor
Department of Rehabilitation and Aged Care, Flinders
University, Adelaide, SA.
Len C Gray, MB BS, PhD, FRACP, Professor
Centre for Research in Geriatric Medicine, University of
Queensland, Brisbane, QLD.
Ian D Cameron, MB BS, PhD, FAFRM(RACP), Professor
Rehabilitation Studies Unit, University of Sydney, Sydney,
NSW.
Correspondence: Dr Lynne C Giles, Department of
Rehabilitation and Aged Care, Flinders University, GPO Box
2100, Adelaide, SA 5001. Lynne.Giles@flinders.edu.au
The distribution of health services for older people in
Australia: where does transition care fit?
Lynne C Giles, Julie A Halbert, Len C Gray, Ian D Cameron and Maria Crotty
What is known about the topic?
As older people move between hospitals and the
community and residential aged care sectors,
problems may arise at the interface of the sectors.
The distribution of specialised acute and subacute
hospital services for older people at a state/territory
level has been reported previously, prior to the
introduction of the Transition Care Program which
explicitly aims to improve the flow between sectors.
What does this paper add?
This study describes the distribution of both hospital
and aged care services at Aged Care Assessment
Team region level. The findings highlight the uneven
distribution of many acute and subacute hospital
services and aged care services, including
transition care.
What are the implications for practitioners?
The findings demonstrate the importance of an
integrated approach to optimise the delivery of
health and aged care services. If population-based
planning benchmarks of the ideal number of
rehabilitation beds for older people could be
developed in tandem with the expansion of the
Transition Care Program, greater effects on flows
across hospitals and community and residential
aged care sectors would be likely to occur.