title: Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?
abstract: BACKGROUND
  in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population.
  
  
  METHODS
  four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported.
  
  
  RESULTS
  over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008.
  
  
  CONCLUSIONS
  growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.
authors.affiliation: Freemasons' Department of Geriatric Medicine, University of Auckland, New Zealand. j.broad@auckland.ac.nz
authors.forename: Joanna B
authors.initials: JB
authors.lastname: Broad
authors.forename: Michal
authors.initials: M
authors.lastname: Boyd
authors.forename: Ngaire
authors.initials: N
authors.lastname: Kerse
authors.forename: Noeline
authors.initials: N
authors.lastname: Whitehead
authors.forename: Carol
authors.initials: C
authors.lastname: Chelimo
authors.forename: Roy
authors.initials: R
authors.lastname: Lay-Yee
authors.forename: Martin
authors.initials: M
authors.lastname: von Randow
authors.forename: Susan
authors.initials: S
authors.lastname: Foster
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Connolly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000639:trends*; D006699:Home Care Services / Q000639:trends; D006707:Homes for the Aged / Q000706:statistics & numerical data / Q000639:trends*; D006742:Hospital Bed Capacity; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D020380:Needs Assessment / Q000639:trends; D009520:New Zealand; D009735:Nursing Homes / Q000706:statistics & numerical data / Q000639:trends*; D013997:Time Factors