news
Call to help revamp ACFI
Minister says changes to ACFI will help
support system stability and sustainability.
M
inister for Aged Care Ken Wyatt has released a new report
canvassing options to modify the Aged Care Funding
Instrument (ACFI).
The report, Review of the Aged Care Funding Instrument,
was prepared by research and analysis company Applied Aged
Care Solutions (AACS). Wyatt said the review would inform the
government’s continuing aged care reforms.
Funding volatility and the lack of predictability with the aged
care forward budget estimates have been major issues for both the
government and the sector, the report said. It held that modifying
the way funding is determined is important to ensure the stability and
sustainability of the system and that it remains one in which evidence-
based assessment results in the best possible care for residents.
“Ageing of the population will put pressure on the system that
will need to be scalable as the industry grows,” the report said. “The
changes made to ACFI will support system stability, sustainability and
cost containment.”
Report author and owner of AACS Dr Richard Rosewarne
said a significant change laid out in the review surrounds pain
management. “The new ACFI broadens the base of therapy and
makes it available to every resident … and enables a wide range of
therapists to be involved.”
Of the report, he said: “What we’re trying to do is give the sector
some of the thinking that’s available to them and they can then
participate in the debate about it. Everything here is out in the open.”
He added the second aspect of the report, external assessment,
applies irrespective of the funding model that is chosen and will be a
part of the landscape moving forward.
Wyatt said the AACS report adds to the options provided in a
recent University of Wollongong report.
The government-commissioned study, released in April this year,
outlined five potential funding options for the sector.
Of the options put forward, the UOW team recommended that
the government move forward with a blended payment model with
fixed and variable costs and suggested a refinement of the current
model in the short term.
Wyatt said no decisions had been made on the best way forward
and added the next step is a Resource Utilisation and Classification
Study, which is now underway at UOW’s Australian Health Services
Research Institute. ■
Antimicrobial prescribing
Survey reveals high rate of prescribing for residents who
did not meet objective clinical criteria for infection.
A
lmost one in 10 aged care residents
are prescribed an antimicrobial
in Australia, and in many cases
details of these prescriptions are not being
documented, a national survey has found.
The aged care National Antimicrobial
Prescribing Survey (acNAPS) revealed
that the reason for the antimicrobial
prescription and review or stop date was
not documented for 22.1 per cent and
49.3 per cent of antimicrobials prescribed,
respectively.
A fifth of antimicrobials had been
administered for longer than six months.
The annual audit of the prevalence of
infections and antimicrobial prescribing
practices in Australian aged care homes
aimed to help providers identify infections
and look for opportunities to improve use.
The preliminary results of the survey,
conducted between June and September
2017, also revealed a high rate (33.2 per
cent) of prescribing for residents who
did not meet objective clinical criteria
for infection in the week prior to starting
antibiotics.
About a third (29.5 per cent) of
antimicrobial prescriptions were for topical
use. Skin or soft tissue (31.7 per cent),
urin ary tract (26.7 per cent) and respiratory
tract (20.8 per cent) infections were
the three most common indications for
prescribing antimicrobials.
This year, the acNAPS team reviewed the
medication charts of 12,344 permanent,
respite or transitional care residents from
293 homes.
Professor Karin Thursky, director of
the National Centre for Antimicrobial
Stewardship, said monitoring the quality
of antimicrobial use in aged care homes is
especially important as elderly residents are
vulnerable to infections and, therefore, more
likely to be receiving antimicrobial therapy.
“This type of review enables
participating homes to reflect on
opportunities to improve the safety and
quality of antimicrobial use. Improved
documentation, and careful review of the
ongoing need for prolonged therapies, are
possible target issues.
“We strongly recommend that all
Australian aged care homes and multi-
purpose services participate in the
acNAPS in 2018 as part of their quality
improvement activities,” Thursky said. ■
agedcareinsite.com.au
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