Transition Care Into The Future

Lesley Podesta

First Assistant Secretary

Ageing and Aged Care Division

2

History of the Transition Care Program

Established in 2004-05 Aims to improve the interface between

the health and aged care systems. Initial commitment was 2,000 places

by 2007-08

3

Transition Care – the present

As at September 2009 there were: 79 transition care services 66% delivered in community 34% delivered in residential setting

4

Transition Care – total places

As at September 2009 there were: 2,499 operational places Average length of stay – 7 weeks This means 18,500+ people can

access transition care services each year

5

The Future of Transition Care

The Transition Care Program will double from 2,000 to 4,000 places by 2011-12 The recurrent costs of these additional places are fully funded by Australian

Government Improved access for Aboriginal and Torres Strait Islander peoples and people

with dementia

6

How are these places being rolled out?

1st tranche - 228 places allocated in 2007-08, all operational in 2008-09

2nd tranche – 470 places allocated in 2008-09, of these 271 operational at 14 Sept 2009

3rd tranche – around 600 places to be allocated by 31 March 2010, to become operational in 2010-11

4th tranche – around 700 places to be allocated by 31 March 2011, to become operational by 2011-12

7

Where are transition care services located?

In 2008-09 53% in major cities 29% in inner regional 15% in outer regional 0.02% in remote areas

8

How much is the Australian Government spending on transition care?

2005-06 – $3.3 million 2006-07 – $33 million 2007-08 – $53 million 2008-09 – $76 million 2009-10 – $103 million 2010-11 – $150 million 2011-12 – $220 million 2012-13 – $224 million

9

Models of Transition Care

Three Transition Care models Predominantly Community

High average MBI, allied health hours Low nursing, medical hours

Residential High allied health, nursing, medical hours Low average MBI

Mixed Low average MBI, mainly located in Victoria

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Results from transition care

Key findings from the 2008 evaluation were: It provided additional treatment and care options

that were valued by patients and their families Functional improvements occurred. There was variation in access to the program

across Australia. Older people who received transition care had

fewer readmissions to hospital and were less likely to move into permanent residential aged care.

11

Transition care and sub-acute care

Transition care was found, in the evaluation, to work best when not used as a substitute for conventional sub-acute care or appropriate geriatric evaluation and management

12

Increase in Activity - discharges from 2006-2009

Transition Care Program - Discharges

621

5,990

9,776

12,230

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

FY2006 FY2007 FY2008 FY2009

Series1

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Discharge Destinations 2006-2009

TCP Discharge DestinationsFY2006-FY2009

1.8%

22% 21%

49%

1.6%5%

0

2000

4000

6000

8000

10000

12000

14000

16000

Death To Hospital To residentialcare

Comm with orwithout support

To other tcservice

Other

14

Functioning – Improved & Maintained 2006-2009

TCP Improved / Improved & MaintainedFY2006 - FY2009

63.959.0 60.5 60.3

73.376.1 78.5 79.5

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

FY2006 FY2007 FY2008 FY2009

15

Continuous Improvement - Transition Care Working Group

Oversees implementation of new 2,000 places and operations of TCP Has representation from all state and territory health departments Includes two clinicians, Professor Leon Flicker (WA) and Dr Paul Varghese

(QLD) Chaired by the Department

16

Transition Care Working Group

• Review of Transition Care Program Guidelines, including • Improved access for Indigenous people• Improved access for people with dementia• Leave from transition care• Development of long-term quality framework

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Reform and transition care

National Health and Hospitals Reform Commission

Ongoing role of transition care Increased focus on primary care

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Transition care into the future

The need for improving the interface between the health and aged care systems is clear

Significant expansion and quality improvement of the transition care is in the pipeline