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The aged care algorithm deciding support for older Australians

From ABC Australia · () English

Summarized and contextualized by DistantNews.

At a glance

In-depth Documents & data Under investigation
  • A new algorithm is deciding aged care funding in Australia, replacing human clinical judgment in final decisions.
  • The algorithm, introduced in November, has faced controversy and government resistance to releasing design documents.
  • Experts like Kathy Eagar argue the algorithm is flawed and should be replaced entirely.

Ninety-six-year-old Audrey Staniland's recent assessment for in-home aged care funding marked a significant shift in the system, with a "classification algorithm" now playing a decisive role. Her daughter, Jan Helgeland, applied for a reassessment late last year, expecting a human clinician to make the final determination, only to discover the clinician's hands were tied by the algorithm's output.

It can only be fixed by ditching the whole algorithm and starting again, if you think that it's better to have an algorithm [rather] than an expert clinical assessor determine what a person needs.

— Kathy EagarKathy Eagar, an expert on health care algorithms, expressed her view on the flawed system.

Introduced in November, the algorithm has been embroiled in controversy. The Australian government has faced mounting pressure from the opposition and crossbenchers to disclose documents detailing its design, but has largely resisted these calls. This lack of transparency has fueled concerns about the fairness and accuracy of the system.

Kathy Eagar, a leading expert on health care algorithms in Australia, has critically examined the algorithm's opaque workings. She firmly believes the system is fundamentally flawed and advocates for its complete overhaul. "It can only be fixed by ditching the whole algorithm and starting again, if you think that it's better to have an algorithm [rather] than an expert clinical assessor determine what a person needs," Eagar stated.

I was very worried about a computer making a decision on a human being [rather] than the person in the room [who] could see mum's condition.

— Jan HelgelandJan Helgeland voiced her concerns about the algorithm's role in her mother's aged care assessment.

An investigation by Four Corners, utilizing Professor Eagar's analysis, evidence from Senate estimates, and Freedom of Information documents, has shed light on the secretive algorithm impacting thousands of older Australians. Helgeland recounted her experience during Audrey's assessment in January, expressing deep concern about a computer dictating her mother's care needs. The assessor used the Integrated Assessment Tool, a questionnaire with over 500 questions, while Audrey's condition was observed. Despite Audrey's age, blindness, emphysema, and living alone, the outcome of the assessment was not immediately favorable for increased funding, leading to reduced care hours.

It was a tick and flick.

— Jan HelgelandJan Helgeland described the process of the clinical assessor inputting information into the assessment tool.
DistantNews Editorial

Originally published by ABC Australia. Summarized and contextualized by our editorial team with added local perspective. Read our editorial standards.

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