Towards equity in long-term care

There are considerable similarities and overlap in the levels of disability and dependency between those who receive home-based-long-term care and those who receive long-term care on a residential basis. These similarities are demonstrated from analysis of clients of the Western Domiciliary Care and Rehabilitation Service. When services are costed, it is shown that there is a very large discrepancy in the levels of government support that clients of home-based care agencies attract compared to residents in subsidised hostels and nursing homes. This paper discusses the need for parity of funding to care providers and recognition of the economic value of the contributions of carers. It considers principles for the development of a casemix model for home-based care analogous to the Care Aggregated Module/Standard Aggregated Module (CAM)/(SAM) model applying to nursing home care.