Lack of integration between home support and primary care: report

Published 1st August 2018

A new report on Australia’s primary health care system has found a lack of integration between primary care services and the home support sector.

The Grattan Institute’s mapping primary care in Australia report calls for an overhaul of primary care and recommends new funding, payment and organisational arrangements for better long-term care for the increasing number of older Australians living with complex and chronic conditions.

Demand for home and community support has increased dramatically, the report says.

But while innovation and technological improvements have made it easier to provide services in the home environment, informal community support is decreasing as families shrink and become more mobile and more women join the workforce.

The report says the scope and reach of home care organisations has expanded but concludes there is “insufficient integration between primary care services and the home care support sector”.

Paul Ostrowski, chief executive of  in-home care package provider Care Connect, said better integration between primary caregivers and home support services would be a positive step, but warned against “medicalising” home care.

“A closer relationship is only going to be in the consumer’s best interests,” he told Community Care Review.

“That does not mean that I think we she should medicalise home care, because the evidence is that psychosocial supports actually bring some of the best outcomes. But at the same time, where there are potentially primary health care matters to deal with, then absolutely we need that close integration.”

Meanwhile, the report describes the drop in the number of indigenous people in home care over the last three years as concerning.

According to a 2017 Aged Care Financing Authority report 330 fewer indigenous Australians were receiving home care in 2016 than in 2013.

“It is concerning that the number of indigenous people in home care declined from a peak of 2035 in 2013 to 1705 in 2016,” the Grattan report says.

“Those numbers would generally be expected to rise, because the population is ageing.”

The report says efforts have been made to ensure indigenous Australians and people from culturally and linguistically diverse backgrounds have equitable access to care, including the introduction of flexible aged care programs.

However, “there is limited data available on whether these measures are truly improving access”, it says.

Home support in Australia 2015-16

• Commonwealth spent $3.8 billion on home care and support
• 1 million people received CHSP services at a total cost of $2.2 billion
• 88,000 received a HCP at a cost of $1.5 billion.
• About 40 per cent of those allocated a HCP had to wait more than three months
• 496 providers delivered HCPs and 1,686 provided CHSP
•  About 130,000 people worked in home care and support including 86,000 direct care workers