What is ROSA?
The Registry of Older South Australians (ROSA) monitors the health, service utilisation, medication use, mortality, and other outcomes of people receiving aged care services in South Australia. ROSA’s efficient model leverages existing information, bringing together diverse datasets collected by different organisations throughout the country, to provide us with a whole picture of the ageing pathway. ROSA will produce evidence to guide decision-making for quality, coordinated, efficient, innovative and age-friendly services and practices.
ROSA was established in 2017 by the Healthy Ageing Research Consortium (HARC), a cross-sectoral partnership of researchers, clinicians, aged care providers and consumer advocacy groups. The Consortium is coordinated under the auspices of the SA Academic Health Science and Translation Centre and is a collaboration between 13 organisations: the South Australian Health and Medical Research Institute (SAHMRI), 3 universities (University of Adelaide, University of South Australia, and Flinders University), 5 industry partners (Helping Hand, Silver Chain, ECH, Adelaide PHN, Country SA PHN), 2 consumer health advocacy groups (COTA SA, HCA SA), SA NT DataLink, and SA Health.
2.6% aged 85+
South Australia has the highest proportion of people aged 85+ in Australia.
17.7% aged 65+
South Australia has the second highest proportion of people aged 65+ in Australia.
This high proportion of older people in SA is projected to increase by 12-20% by 2027.
Ageing Population: South Australia has the highest proportion of residents over 85 (2.6%) years old and the second highest proportion of residents over 65 (17.7%) years old in the country. This high proportion of older residents is projected to increase by 12-20% by 2027. As these residents age they are more likely to need aged care services. The aged care sector is a $16 billion industry, with the Australian Government subsidising a significant portion of the costs, although many service recipients must also contribute significantly to the cost of their use of aged care services.
Complexity of Aged Care Services: Aged care services typically fall into three main categories- home support, home care packages, and residential care. Aged care services and their provision have changed dramatically in the last couple of decades due to significant changes in aged care legislature reform, demographics and health needs of the recipients, as well as preferences for certain services. As of 2016 the point of entry for any access to government subsidised services is ‘My Aged Care.’ This portal provides aged care seekers with information regarding services available and allows for request for eligibility assessments for more in-depth needs.
In 2014/15 financial year 16,283 South Australians had Comprehensive Assessments performed by Aged Care Assessment Teams (ACAT). Of these, 12,880 were admitted into residential aged care (5,720 into permanent care and 7,160 into respite care) and 3,146 were provided with home care. In the same year, there were 17,678 operational residential care places in South Australia, which is 9% of the 176,967 national places.
Opportunities for Aged Care Improvement: South Australia’s demographics place it perfectly to harness the benefits and address the challenges of the longevity revolution; a success of modern life adding decades to life expectancy. The State’s Prosperity Through Longevity vision identifies the need to: address the increasing demand for costly health services and other supports; reduce age-discrimination impacting on life and employment participation; foster civic participation of older people; continue the indispensable contribution of volunteering; create a state that is all-ages friendly; and promote the community and social assets of older South Australians including the unique contribution of Aboriginal Elders.
ROSA currently has two components: 1) A prospective state-wide registry (Prospective ROSA) which launched in mid 2018 and seeks to enrol all older South Australians who have an aged care eligibility assessment performed by an Aged Care Assessment Team (ACAT) from April 2018 onwards. 2) A historical nation-wide registry (Historical ROSA) which contains completely de-identified data from all Australians who were assessed for and/or received government-subsidised aged care services from 1997-2016.
Note: All data included in the ROSA registries are existing data routinely collected by either the Australian Commonwealth Government or the South Australian State Government bodies. ROSA has appropriate Human Research Ethics Committee approval and data custodian permission to link these existing data sources to form a more complete picture of the complete ageing journey and how our older people use health and aged care services.
Prospective ROSA (mid-2018 onwards)
The South Australian state-wide Prospective ROSA rolled out across the 4 Local Health Networks in the state between April and August 2018. Since August 2018, all older South Australians being assessed for aged care eligibility by an Aged Care Assessment Team (ACAT) are provided with the ROSA Participant Information Statement for Opt-Out Consent in the ACAT information pack. This provides comprehensive information about ROSA and also includes information on how to opt-out or withdraw from the Registry if the older person or their guardian feels strongly about not being included in ROSA.
Prospective ROSA links Commonwealth aged care data, death records, Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data to South Australian hospitalisation and emergency room encounter datasets. By bringing together these diverse datasets collected by different organisations throughout the country it will provide us with a whole picture of the ageing pathway. ROSA will produce evidence to guide decision-making for quality, coordinated, efficient, innovative and age-friendly services and practices for older South Australians.
The Prospective stage of ROSA has been reviewed and approved by the following Human Research Ethics Committees (HREC): South Australian Department for Health and Ageing HREC (Ref: HREC/17/SAH/125; March 2018 and the Australian Institute of Health and Welfare (AIHW Ref: EO2018/2/429; May 2018).
Historical ROSA (1997-2016)
The Historical ROSA is a nation-wide registry which contains completely de-identified data from all Australians who were assessed for and/or received government-subsidised aged care services from 1997-2016. It includes national aged care data and death records from 1997-2014, and will soon also be linked to de-identified Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) records for the period 2002-2016.
The Historical stage of ROSA has been reviewed and approved by the following Human Research Ethics Committees (HREC): University of South Australia HREC (Ref: 200487; October 2017), Australian Institute of Health and Welfare (AIHW Ref: EO2018/1/418; February 2018).
Establish and maintain ROSA, which will generate a unique data collection with analytic capability to guide evidence-driven decision making for quality, coordinated, efficient and age-friendly services and practices;
Support the conduct of health and medical research to answer the questions of industry, NGO and government sectors in relation to positive and healthy ageing;
Produce evidence for cost-effective service innovations, models of care and other solutions for the sector;
Enable the monitoring of the quality of ageing over time;
Promote community engagement and intergenerational learning;
Generate direct employment change through research, changes in business and service delivery models, plus broader economic development opportunities generated by positive ageing; and
Establish a ‘Living Laboratory’, which will provide a resource for trialling new and emerging ideas.