Clustered domestic residential aged care in Australia: fewer hospitalisations and better quality of life

Objective: To compare the outcomes and costs of clustered domestic and standard Australian models of residential aged care. Design: Cross‐sectional retrospective analysis of linked health service data, January 2015 – February 2016. Setting: 17 aged care facilities in four Australian states providing clustered (four) or standard Australian (13) models of residential aged care. Participants: People with or without cognitive impairment residing in a residential aged care facility (RACF) for at least 12 months, not in palliative care, with a family member willing to participate on their behalf if required. 901 residents were eligible; 541 consented to participation (24% self‐consent, 76% proxy consent). Main outcome measures: Quality of life (measured with EQ‐5D‐5L); medical service use; health and residential care costs. Results: After adjusting for patient‐ and facility‐level factors, individuals residing in clustered models of care had better quality of life (adjusted mean EQ‐5D‐5L score difference, 0.107; 95% CI, 0.028–0.186; P = 0.008), lower hospitalisation rates (adjusted rate ratio, 0.32; 95% CI, 0.13–0.79; P = 0.010), and lower emergency department presentation rates (adjusted rate ratio, 0.27; 95% CI, 0.14–0.53; P