Final Report on RREF 2001 - Department of Health

Part B: Development of Options for a Revised RREF
Three options emerged as alternatives to maintaining the current RREF option of including all
those aged 85 and over living in the community:
1. Include only those with moderate, severe and profound handicap at all
ages. The basis for not making any further adjustment for advanced
age is that the frail aged could be defined as those with handicaps and
so those who do not have a handicap are not part of the HACC target
population.
2. Lower the age for defining the frail aged to 70 years and over to reflect
the predominance of this age group in the HACC client population.
One advantage that could be claimed for this approach is consistency
with the aged residential care planning ratios; however, those ratios
apply only to the aged population, so the issue of relativity to younger
age groups does not apply. The disadvantage of this option is that it
includes a substantial number of older people who are not within the
HACC target population because they do not require assistance in daily
living activities and for social participation. While the total aged
population comes within the scope of health promotion programs,
primary prevention is beyond the scope of HACC.
3. Give additional weight to the moderately, severely and profoundly
handicapped population aged 70 and over. Figure 2 gives a guide to
added weight that would bring the frail aged population identified by
DACS more into line with the representation of older age groups in the
HACC client population, which shows that shares of the HACC client
population in the age groups over 70 are approximately double their
shares of the DACS population. Accordingly, this segment of the base
population has been doubled in the third option. This option has the
advantages of consistently defining the target population on the basis of
disability, and focusing on the secondary prevention functions of
HACC for a client population with established disability.
The effects on the age balance of the total base population arising from adjusting for the frail
aged in the current RREF and these three options can be seen in Table 1.3 which compares:
• the numbers and proportions aged under and over 70 for the total Victorian
population;
• the HACC client population under and over 70;
• the current RREF; and
• the three options for RREF base populations calculated on the statewide prevalence
of moderate, severe and profound handicap and with different adjustments for the
frail aged.
<strong>Final</strong> <strong>Report</strong> July 2001 21