Historical Trends of Home Care Package Use for Older People in Australia, 2008–2021

To the Editor:
The global population is aging, and the health and social care needs of older people become increasingly complex. The diverse demographic, along with an increased preference of aging in place, has altered the demand and provision of long-term aged care services, both in quantity and type. In Australia, long-term aged care services can be delivered at home through the Australian Government Home Care Package (HCP) Program, or in nursing homes (also known as aged care facilities). The HCP program was introduced in August 2013, consolidating 3 types of community-based care packages that operated since 1985. In its current form, HCPs are bundled, structured, and comprehensive care services, catering individuals who need ongoing support to live at home. The eligibility to HCP and level of care, which ranges from basic (level 1) to high (level 4) care, are determined by a clinical assessor at aged care eligibility assessment. In 2020–2021, 185,605 assessments were administered nationally. Since its inception, the HCP program has undergone several reforms targeting improvements in accessibility, flexibility, and affordability. However, the provision of HCP remains inadequate despite multiple expansion efforts. Our study investigated the national changes and trends in the HCP service utilization between 2008–2009 to 2020–2021, during these community aged care services integrations and reforms...