Socioeconomic profiles of older people entering long-term care: a national evaluation using the Registry of Senior Australians

OBJECTIVES AND IMPORTANCE OF STUDY: Social welfare has a critical role in supporting older people accessing long-term care, yet a national evaluation of income support for this population has not been conducted. This study investigates the socioeconomic profiles of older people accessing long-term care in Australia. It focuses on composition and changes in income sources, including social welfare payments and non-government income at individuals' first interaction with the sector. STUDY TYPE: Cross-sectional analysis using the Registry of Senior Australians National Historical Cohort. METHODS: The study included individuals aged ≥65 years who had a long-term care eligibility assessment between 1 January 2010 and 31 December 2019. Descriptive analyses were employed using income data from the 12 months before assessment, adjusted using the quarterly Consumer Price Index Indicator for January 2020. RESULTS: The cohort included 921,208 individuals (median age 82 years, 58.7% female, 60.7% homeowners). Between 2010 and 2019, the percentage of individuals receiving social welfare payments when entering long-term care remained consistent at approximately 91%, and the median (interquartile range, IQR) annual amount received increased from AU$19,852 (IQR $15,964-$21,342) to $20,630 (IQR $17,777-$24,172). The percentage reporting non-government income increased from 12.0% in 2010 to 30.0% in 2019; however, the median non-government income was highly skewed and decreased from $5,438 ($376-$107,389) to $1,679 ($131-$10,867). Those in the highest income quintile received a smaller proportion of their income from social welfare payments (58.8%) compared with the lower quintiles (between 83.6% and 91.3%), and reported higher levels of non-government income, including employment (2.4% in highest income quintile vs 0.5% in lowest quintile), unearned continuous income (18.9% vs 6.7%) and business income (20% vs 1.5%). Non-homeowners reported higher total income than homeowners (median: $23,841 vs $20,800). CONCLUSIONS: Approximately nine in 10 older people in Australia accessing long-term care received social welfare payments, with substantial non-government income limited to those in the highest income quintile.