Discursive constructions of consumer choice, performance measurement and the marketisation of disability services and aged care in Australia

2020 ◽  
Author(s):  
Patrick O'Keeffe ◽  
Christina David
Keyword(s):  
Performance Measurement ◽  
Consumer Choice ◽  
Aged Care ◽  
Disability Services ◽  
Choice Performance ◽  
Discursive Constructions

Accommodation payment plans in residential aged care: The impact of consumer choice

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Olukorede Abiona ◽  
Serena Yu ◽  
Mike Woods ◽  
Kees van Gool
Keyword(s):  
Consumer Choice ◽  
Aged Care ◽  
Residential Aged Care ◽  
The Impact

scholarly journals Clustered domestic model of residential care is associated with better consumer rated quality of care

2018 ◽  
Vol 31 (6) ◽  
pp. 419-425 ◽  
Author(s):  
Emmanuel S. Gnanamanickam ◽  
Suzanne M. Dyer ◽  
Rachel Milte ◽  
Enwu Liu ◽  
Julie Ratcliffe ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Quality Of Care ◽  
Residential Care ◽  
Consumer Choice ◽  
Aged Care ◽  
Models Of Care ◽  
Summary Score ◽  
Residential Aged Care ◽  
Cross Sectional

Abstract Objective To compare consumer rated quality of care among individuals living long-term in homelike clustered domestic and standard models of residential care in Australia. Design Cross-sectional study. Setting Seventeen residential aged care facilities in four Australian states providing alternative models of care. Study participants A sample of individuals with high prevalence of cognitive impairment living in residential care for 12 months or longer, not immediately in palliative care and having a proxy available to provide consent and assist with data collection. Of 901 eligible participants, 541 consented and participated in the study. Main outcome measure Consumer rated quality of care was measured using the Consumer Choice Index–6 Dimension instrument (CCI-6D) providing a preference weighted summary score ranging from 0 to 1. The six dimensions of care time, shared-spaces, own-room, outside and gardens, meaningful activities and care flexibility were individually evaluated. Results Overall consumer rated quality of care (Mean ∆: 0.138, 95% CI 0.073–0.203 P < 0.001) was higher in clustered domestic models after adjusting for potential confounders. Individually, the dimensions of access to outside and gardens (P < 0.001) and flexibility of care (P < 0.001) were rated significantly better compared to those living in standard model of care. Conclusions Homelike, clustered domestic models of care are associated with better consumer rated quality of care, specifically the domains of access to outdoors and care flexibility, in a sample of individuals with cognitive impairment. Including consumer views on quality of care is feasible and should be standard in future evaluations of residential care.

The marketization of care: Global challenges and national responses in Australia

2018 ◽  
Vol 66 (4) ◽  
pp. 503-516 ◽  
Author(s):  
Michael Fine ◽  
Bob Davidson
Keyword(s):  
Consumer Choice ◽  
Historical Sociology ◽  
Aged Care ◽  
Private Capital ◽  
The Public ◽  
For Profit ◽  
The Right ◽  
The Life Course ◽  
Political Economic ◽  
Provision Of Care

Care is a social necessity for life. Ensuring access to appropriate care at crucial points in the life course became a political necessity soon after the mid-20th century, as the right to suitable care became recognized as a fundamental entitlement of citizenship in most advanced capitalist economies. Over recent decades there has been a shift away from more traditional welfare state forms of public services towards increasingly marketized systems of provision. Changes in the provision of care in the public domain are associated with an increasing reliance on private capital and competition between a variety of providers, with public agencies competing alongside private for-profit and not-for-profit agencies. Drawing on care theory, historical sociology and political economic analysis, this article examines the conflicting tensions that shape aged care under marketization. Using Australia as a case study, it is argued that as private capital and resources take the place of scarce public resources and enable expenditure cuts to be presented as innovation, better services and more ‘consumer choice’, it is not the market but the finance, regulation and management work of the state that is the essential determinant of the assistance previously provided through non-market processes.

Post-diagnosis young-onset dementia care in the National Disability Insurance Scheme

2021 ◽  
pp. 000486742110116
Author(s):  
Monica Cations ◽  
Sally Day ◽  
Kate Laver ◽  
Adrienne Withall ◽  
Brian Draper
Keyword(s):  
Best Practice ◽  
Online Survey ◽  
Disability Insurance ◽  
Aged Care ◽  
Disability Services ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Young Onset ◽  
Care Partners ◽  
Young Onset Dementia

Objective: Post-diagnosis service delivery for young-onset dementia (with onset prior to 65 years) recently moved to the disability system in an attempt to address systemic barriers to best practice in aged care. The objective of this study was to examine experiences and satisfaction with disability services so far among people with young-onset dementia and their care partners and identify strategies for service and system improvement. Methods: The 151 participating Australians living with young-onset dementia or providing informal care to a person with young-onset dementia were recruited via social media, advocacy bodies and specialist medical clinics. A cross-sectional online survey asked participants to provide a timeline of their interactions with the disability system so far and rate their satisfaction with the disability system, aged care and disability services. Results: Participants reported a mean age at symptom onset of 55 years. In all, 53% were diagnosed with Alzheimer’s disease and 25% were diagnosed with frontotemporal dementia. Sixty percent had received an approved plan from the National Disability Insurance Scheme, although 3% were rejected. More than 27% waited longer than 6 months to receive their plan, and half waited at least a month post-approval to access services. Less than 30% agreed that the National Disability Insurance Scheme understands dementia, and fewer than half felt that the process of accessing National Disability Insurance Scheme funding is easy and fast enough. Nonetheless, respondents remained overwhelmingly in favour of young-onset dementia services remaining in the disability system rather than in aged care. Conclusions: While people with young-onset dementia and their care partners strongly agree with their inclusion in the National Disability Insurance Scheme, a relatively low level of experience with dementia in the disability workforce and a lack of integration with the healthcare and aged care systems continue to create important barriers for accessing the services they need.

scholarly journals MEASURING CLIENT EXPERIENCE IN RESIDENTIAL AGED CARE TO INFORM AND SUPPORT CONSUMER CHOICE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S507-S507
Author(s):  
Deirdre M Fetherstonhaugh ◽  
Yvonne Wells ◽  
Angela Herd
Keyword(s):  
Consumer Choice ◽  
Reference Group ◽  
Care Home ◽  
Aged Care ◽  
Care Quality ◽  
Residential Aged Care ◽  
Biased Sampling ◽  
Consumer Experience ◽  
Client Experience ◽  
Accreditation Standards

Abstract The Australian Government Aged Care Quality and Safety Commission (prior to January 2019 known as the Australian Aged Care Quality Agency) is responsible for accreditation of Australian aged care services which are audited against the Australian Accreditation Standards. Accreditation reports are publicly available. Prior to 2017, some clients were interviewed about their experiences, but the resulting information could not represent the client experience within a service due to low numbers, biased sampling, and an unsystematic approach to asking questions. La Trobe University was engaged to develop and pilot an interview tool to measure client experience for use in accreditation. Potential questions were identified through a literature review, mapped against the Accreditation Standards, and workshopped with an expert reference group. Twenty-four questions and a visual analogue were then piloted. Consumer groups and groups of Indigenous and culturally diverse clients in residential aged care homes were consulted. The perspective of Quality Agency surveyors was sought on the questions’ usability. Statistical analyses sought to identify questions that minimised missing data, were responded to similarly by residents and their representatives, and elicited stable responses on retest. Twelve questions were identified as optimal. The 10 quantitative questions proved to reflect a single underlying dimension (consumer experience) and, when summed and explored through regression analyses, differentiated services significantly. The consumer experience interview tool is now used in all accreditation audits in Australia. Results are then used to generate consumer experience reports, which are published online and can support consumer choice of a residential aged care home.

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