Has consumer-directed care in community aged care improved quality of life for older Australians?

The Australian Government has recently committed to major policy reform in aged care, with the widespread introduction of consumer directed care (CDC) in community care. The main aims of this study were to assess the impact of CDC on the quality of life of older Australians. Quality of life was assessed using the EuroQoL 5 dimensions 5 level (EQ-5D-5L) and the older people-specific capability index (ICECAP-O). The relationships between quality of life, length of time receiving CDC and socio-demographic characteristics were examined using descriptive statistical and multivariate regression analyses. 484 older people were approached of whom 150 (31\ consented to participate. Mean quality of life scores were 0.56 (sd=0.26) and 0.76 (sd=0.17) according to the EQ-5D-5L and the ICECAP-O respectively. Sub-group analysis revealed slightly higher quality of life scores for both instruments for those in receipt of CDC for ≤12 months [0.57 (0.25) and 0.78 (0.15)] compared to \gt;12 months [0.54 (0.25) and 0.72 (0.18)]. However these differences were not found to be statistically significant. Although little variation was found overall in quality of life outcomes according to the length of exposure to CDC for either the EQ-5D-5L or ICECAP-O, analysis at the dimension level suggested that those with a longer period of exposure had stronger capability in being able to do things that made them feel valued. These cross-sectional results should be interpreted with caution and longitudinal follow up is needed to facilitate a detailed examination of the relationship between CDC and its longer-term influences on quality of life.