Monitoring cross-setting care and outcomes among older people in aged care: a national framework is needed.

Establishing an evidence-based framework to monitor and evaluate quality and safety of care for older people is critical. Despite progress in health system performance monitoring in Australia, slower progress has occurred for the older population accessing aged care services. With an aging population and increasing demands on aged care and healthcare systems, there is growing recognition of the need for more coordinated and integrated care across settings. It is not uncommon for older people accessing aged care to require a range of services administered by different organisations simultaneously (e.g. primary care, home care) and sequentially (e.g. hospitals, residential care). Aged care also represents an increasingly regulated sector, with significant investment in and growing recognition of the value of quality measurement. Accountability for care quality and safety is often shared among providers, with consequent challenges in attributing responsibility. Therefore, the development of a pragmatic national framework to support high-quality, person-centred care for the older population accessing aged care services across care settings is one opportunity for shared responsibility, care monitoring, and quality improvement activities that could lead to better outcomes for this population. The strategy for framework development proposed in this perspective has implications for aged care and healthcare providers, consumers, policy makers, regulators, and academics. Once implemented, this framework has the potential to drive consistent high-quality care to improve health outcomes and wellbeing among older people accessing aged care services.