Authors: Solomon Ahimah-Agyakwah,1 Jane Hall,1 Maryam Naghsh Nejad,1 and Peyman Firouzi Naeim1
Affiliations:
- Center for Health Economics Research and Evaluation (CHERE), University of Technology Sydney.
The following is a summary of an oral presentation at the 2025 AHES Conference: https://ahes.org.au/wp-content/uploads/2025/09/AHES-Annual-Conference-2025-Abstracts-Booklet_final.pdf
As Australians live longer, a growing number of older adults are spending additional years managing chronic illnesses. This trend places increasing pressure on hospitals and the broader health system, making healthcare delivery more expensive and harder to sustain. One strategy to help ease this strain is through residential aged care — such as nursing homes — where older people can access ongoing care and support services tailored to their needs.
This study examined whether moving into aged care homes actually reduces hospital use, rather than merely being associated with it. Researchers analysed data from over 15 years (2005–2019) involving adults aged 65 and over in New South Wales. They compared hospital use before and after people entered aged care with that of similar individuals who continued living at home.
The results showed that residents of aged care homes generally had fewer hospital admissions and emergency department visits. However, these effects were not consistent across all groups. The extent of hospital use reduction varied depending on factors such as age, gender, relationship status, geographical location, and the types of hospital services used.
Three key mechanisms explained why moving into aged care can lead to fewer hospital visits: prevention, substitution, and management.
Prevention occurs when aged care homes reduce hospital demand by addressing health issues before they escalate. Regular supervision, care plans, and daily support help prevent accidents, medication errors, and other emergencies. The structured environment also ensures that only serious conditions requiring specialised care result in hospital transfers. Additionally, increased social interaction within aged care homes can improve mental health and lower stress-related health risks.
Substitution refers to the fact that many hospital-level services are directly provided within aged care settings. Trained staff, including registered nurses, personal care workers, and allied health professionals, deliver much of the care that older adults would otherwise seek in hospitals.
Management involves continuous monitoring and early intervention, ensuring that health problems are treated promptly. Only conditions that cannot be safely managed in the facility are referred to hospitals.
In conclusion, improving the quality and accessibility of aged care services can help relieve pressure on hospitals. Ensuring that both public and private aged care homes deliver high-quality care, reviewing entry assessments, and tailoring policies to meet the diverse needs of older Australians are vital steps toward a more sustainable health system.
Source: Unsplash
