Expenditure on Residential Aged Care: Estimation and Implication

Expenditure on Residential Aged Care: Estimation and Implication | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Expenditure on Residential Aged Care: Estimation and Implication Hengzhe Zhao, Jinhui Zhang, Han Lin Shang, Evelyn Lee This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6240978/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract In Australia, residential aged care (RAC) accounts for a significant cost to the sector with financial sustainability and changes in residents’ profiles emerging as critical concern. Our study utilized a longitudinal dataset and design a statistical simulation model to project the profile of individuals entering RAC, the number of admissions, and the associated government spending on RAC. Our approach integrates ensemble model including eXtreme Gradient Boosting and Hamilton–Perry method to provide a precise prediction of residents’ length of stay. In so doing it enables a more reliable forecast of the future RACs landscape. The analysis was conducted on a state level to illustrate regional differences. We examined both the demographic features, such as age, marital status, and sex and the medical features, such as dementia status and aspects represented by the aged care funding instrument (ACFI) among existing and prospective residents. Our models predict that there would be sufficient number of residential beds in most states and territories in Australia. The number of admissions has been decreasing in most states since 2016, while the number of residents kept increasing until 2025. Although the number of residents is expected to decrease, we do not expect that there will be a significant drop in government spending on the sector. The model also lays the ground for future research in the RAC sector by offering micro level insights into the usage pattern and sustainability challenges. Health sciences/Health care/Health care economics Health sciences/Health care/Health policy Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6240978","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":449742626,"identity":"fe20687c-1d8a-4d87-8a75-57bd0df49fbf","order_by":0,"name":"Hengzhe Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEklEQVRIiWNgGAWjYBACAxDB2AAkJID4YwMzVJyNSC2MM0nWwsxLjBZz9t7DL3/usGGQn9388LHtDut8BrHDGxg+lB1m4J+RgFWLZc+5NAvJM2kMjHOOGRvnnkm3bJBOK2Ccce4wg8QN7FoMbuSYGRi2HWZglkgwk85tO2zAIJ1jwMwLFGHApeX+GzODxLb/DGwS6d+kLWFa/gK1yOO0hcf4wcG2Aww8Ejlm0owwLUAGUAqHljM5ZoyNbck8EhI5xYa9bekGbEC/HOw5l85jeOYBdi3Hzxh//NlmJyc/I33jg59t1gb80skbH/wos5aTO47dFiBgA8U7D4ILNOcAiggmYP6AYTUe1aNgFIyCUTACAQD6z1q2d3ryJQAAAABJRU5ErkJggg==","orcid":"","institution":"Macquarie University","correspondingAuthor":true,"prefix":"","firstName":"Hengzhe","middleName":"","lastName":"Zhao","suffix":""},{"id":449742627,"identity":"24e43af4-1604-4033-b8fe-b45e89f37d09","order_by":1,"name":"Jinhui Zhang","email":"","orcid":"","institution":"Macquarie University","correspondingAuthor":false,"prefix":"","firstName":"Jinhui","middleName":"","lastName":"Zhang","suffix":""},{"id":449742628,"identity":"d95c0d88-6412-4c51-9f58-e9f467a6173b","order_by":2,"name":"Han Lin Shang","email":"","orcid":"","institution":"Macquarie University","correspondingAuthor":false,"prefix":"","firstName":"Han","middleName":"Lin","lastName":"Shang","suffix":""},{"id":449742629,"identity":"9855d322-5934-4b24-b8ed-a9e30864a847","order_by":3,"name":"Evelyn Lee","email":"","orcid":"","institution":"The University of Sydney","correspondingAuthor":false,"prefix":"","firstName":"Evelyn","middleName":"","lastName":"Lee","suffix":""}],"badges":[],"createdAt":"2025-03-17 04:53:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6240978/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6240978/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83969028,"identity":"78d28977-2db8-4224-8012-12dbdada0b54","added_by":"auto","created_at":"2025-06-05 07:32:24","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":588649,"visible":true,"origin":"","legend":"","description":"","filename":"tex.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6240978/v1_covered_f62681ea-fc71-4620-aa19-1bf8703dac42.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Expenditure on Residential Aged Care: Estimation and Implication","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6240978/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6240978/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"In Australia, residential aged care (RAC) accounts for a significant cost to the sector with financial sustainability and changes in residents’ profiles emerging as critical concern. Our study utilized a longitudinal dataset and design a statistical simulation model to project the profile of individuals entering RAC, the number of admissions, and the associated government spending on RAC. Our approach integrates ensemble model including eXtreme Gradient Boosting and Hamilton–Perry method to provide a precise prediction of residents’ length of stay. In so doing it enables a more reliable forecast of the future RACs landscape. The analysis was conducted on a state level to illustrate regional differences. We examined both the demographic features, such as age, marital status, and sex and the medical features, such as dementia status and aspects represented by the aged care funding instrument (ACFI) among existing and prospective residents. Our models predict that there would be sufficient number of residential beds in most states and territories in Australia. 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