Government-owned aged care homes linked to fewer hospital visits in Australia
· Medical Xpressedited by Sadie Harley, reviewed by Andrew Zinin
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Experts have raised concerns about a gradual shift in ownership and management models in Australia's aged care facilities—and the subsequent impact this has on the quality of care and resident health outcomes.
A new study published by BMJ Open shows that a gradual decline in the number of government-owned and not-for-profit nursing homes in Australia, in favor of for-profit companies, could see higher rates of hospitalization among older Australians.
The assessment is based on emergency department admissions and unplanned hospital admissions among more than 200,000 long-term care facility residents in the Registry of Senior Australians national cohort (2013–18).
Of the 205,079 residents studied, 8,961 (4.4%) lived in government-owned facilities, 105,144 (51.3%) in not-for-profit homes and 90,974 (44.4%) in for-profit homes.
Flinders University lead author Dr Miia Rahja says the study compared different nursing home ownership models while also examining the important influence that geographic location may have on resident outcomes.
The study found that residents of government-owned aged care homes had fewer hospital-related events, with the differences most evident in Australia's inner-regional areas.
Residents in government-owned homes had a lower emergency department presentation risk than residents in not-for-profit homes. Similar observations were made for unplanned hospitalizations and days spent in hospital across various regions.
The findings come at a time when ownership patterns in Australia's aged care home sector are changing. Several large providers have acquired aged care homes that were previously operated by not-for-profit organizations, reducing the number of providers from 663 in 2023 to 642 in 2024.
Senior author Professor Maria Inacio, who heads the Registry of Senior Australians Research Center (ROSA) and the Flinders Aging Alliance at Flinders University, says ongoing monitoring of aged care home ownership is vital because this has significant potential to affect residents' outcomes.
"Findings from this study agree with the Royal Commission into Aged Care Quality and Safety investigations about the influence of aged care home ownership on the quality and outcomes of individuals in these facilities," Inacio says.
Prior research also shows that for-profit providers are less likely to comply with sector requirements, such as mandatory care minutes.
"Our work confirms the need for financial, quality and social accountability monitoring of aged care home integration given their significant influence on resident outcomes," Rahja says.
Publication details
Miia Rahja et al, Association of long-term care facility ownership and location on residents' mortality and hospitalisations: A population-based retrospective cohort study in Australia, BMJ Open (2026). DOI: 10.1136/bmjopen-2026-117917
Journal information: BMJ Open
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Geriatric palliative careHealthy aging Provided by Flinders University Who's behind this story?
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