Outsourcing bed-based aged care services from a public health service: An observational study

Ms Anne Thompson1, Dr Richard Kane1,3,4, Professor Nicholas Taylor1,2

1Eastern Health, , Australia, 2La Trobe University, , Australia, 3St Vincent’s Health, , Australia, 4Monash University, , Australia

Purpose:  Outsourcing health care services is becoming more common, usually with the goal of reduced costs and increased productivity.  Research suggests that health care outsourcing is complex and there is not one clear method for implementation.  The purpose of this study was to determine if there are differences in quality of care and length of stay between a transition care program designed to improve older people’s independence and confidence after a hospital stay, when provided within a public health network compared to being outsourced to private facilities.

Method: An audit was completed at 3 bed-based sites (1 public, 2 outsourced) for all 1,546 clients discharged over two years.

Findings: Length of stay was a mean of 4.8 days less at the public health network (95% CI 0.5 to 9.1) than outsourced facility 1 and 4.6 days less (95%CI 1.2 to 8.1) than outsourced facility 2. For those discharged to residential care, length of stay was 9.4 days less at the public health network than outsourced facility 1 (95% CI 3.5 to 15.2) and 7.0 days less than outsourced facility 2 (95% CI 1.9 to 12). There was no difference in quality of care measures.

Originality: An internally-managed transition care program in a public health network was associated with a large reduction in length of stay and similar client quality of care outcomes.  This suggests significant advantages to keeping programs managed internally as opposed to outsourcing these services to private facilities.


Anne Thompson is the Associate Director for Student Programs at Eastern Health.  She has had a varied career, commencing as a clinical music therapist before completing post graduate studies and developing a keen interest in research. More recently she has held a number of management roles in healthcare and is passionate about examining the “why” of how systems are run. The work that Anne will be sharing today came from her interest in combining the roles of clinician and researcher.

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