| rating | Overall | Residents’ experience | Compliance | Staffing | Quality measures |
|---|---|---|---|---|---|
| ★★★★★ | 54 | 50 | 1373 | 240 | 579 |
| ★★★★ | 967 | 737 | 476 | 211 | 612 |
| ★★★ | 1358 | 1494 | 610 | 578 | 1017 |
| ★★ | 115 | 234 | 59 | 934 | 161 |
| ★ | 6 | 5 | 6 | 574 | 163 |
Introduction
The service level data for aged care star ratings is now available (Australian Government, Department of Health and Aged Care 2023), but in its unprocessed form it is hard to derive insights from it. In this post I will aim to visualise the star ratings for Q2 FY22-23 using sensible and interesting graphical representations. I will also perform some statistical analysis. However, in general I will leave interpretation to the reader as my priority is to transform the service level star rating data into a more useful format for analysis in a timely manner.
The number of services given each star rating in each category is summarised in Table 1. The distribution of overall star ratings based from this data extract differs slightly from what has been published by Anika Wells MP (2023), but this can be attributed to changes made to ratings between the date of publication of the press release and when the service level data was made available.
Some star ratings are missing in the dataset. Based on the Star Ratings Provider Manual (Australian Government, Department of Health and Aged Care 2022) there are a number of reasons that a star rating may not be available such as: the service has not operated for two reporting quarters of the National Aged Care Mandatory Quality Indicator Program; the service has recently gone through a transfer in ownership; the rating for quality measures or staffing is under review by the department; unavailability of data. Furthermore, the overall star rating can only be determined when all other star ratings are available for that service. The number of star ratings missing in each category is shown in Table 2. The patterns of missingness are shown in Table 3. We can confirm from this table that the overall star rating is only ever available when all other star ratings are also available.
| Unavailable star ratings | |
|---|---|
| Overall | 140 |
| Residents’ experience | 120 |
| Compliance | 116 |
| Staffing | 103 |
| Quality measures | 108 |
| Missing star rating for | Count |
|---|---|
| Overall, Residents’ experience, Compliance, Staffing, Quality measures | 97 |
| Overall, Compliance | 12 |
| Overall, Residents’ experience | 12 |
| Overall, Quality measures | 7 |
| Overall, Residents’ experience, Compliance | 6 |
| Overall, Residents’ experience, Staffing, Quality measures | 3 |
| Overall, Residents’ experience, Staffing | 2 |
| Overall, Compliance, Staffing, Quality measures | 1 |
Overview
While we can determine some results from the table of counts, a more intuitive view is given by a column chart, such as in Figure 1. For overall, residents’ experience, and quality measures, the most common rating is three stars. On the other hand, for staffing the most common rating is just two stars, while for compliance it is five stars. The proportion of services that received each star rating within each category and the mean star rating within each category, along with an estimated 95% confidence interval, is shown in Figure 2. We observe a high average star rating for compliance, but a low average star rating for staffing among services.
The 95% estimated confidence interval, within each star rating category, was calculated as , where
is the sample mean,
is the sample standard deviation, and
is the sample size.
Star rating by size of service
Next we consider the effect of the size of an aged care service on its star ratings. The number of services of each size is shown in Table 4. Figure 3 shows, stratified by service size, the proportion of services that received each star rating within each category and the mean star rating, along with an estimated 95% confidence interval.
| Service size | Count |
|---|---|
| Small | 1120 |
| Medium | 845 |
| Large | 535 |
Star rating by organisation type
The number of services of each organisation type is shown in Table 5. Stratified by organisation type, Figure 4 shows, the proportion of services that received each star rating within each category and the mean star rating, along with an estimated 95% confidence interval.
| Organisation type | Count |
|---|---|
| For profit | 844 |
| Government | 215 |
| Not for profit | 1441 |
Star rating by geography
We consider the modified Monash categories MM1-7 along with groupings of these by MM1, MM2, and MM3-7, and the Australian states and territories. The number of services in each group and how these relate to each other are shown in the alluvial chart in Figure 5.
To get a deeper understanding of the geographical regions in question, you can interact with the map in Figure 6.
Star rating means
The mean of each star rating category stratified by various groupings are available in Table 6.
| Overall | Residents' experience | Compliance | Staffing | Quality measures | N | |
|---|---|---|---|---|---|---|
| Home size | ||||||
| Small | 3.54 | 3.38 | 4.31 | 2.85 | 3.61 | 1177 |
| Medium | 3.28 | 3.15 | 4.23 | 2.19 | 3.43 | 884 |
| Large | 3.19 | 3.06 | 4.16 | 2.05 | 3.41 | 579 |
| Organisation type | ||||||
| Not for profit | 3.35 | 3.27 | 4.18 | 2.32 | 3.54 | 1521 |
| For profit | 3.28 | 3.09 | 4.31 | 2.26 | 3.39 | 901 |
| Government | 3.96 | 3.58 | 4.46 | 4.09 | 3.77 | 218 |
| State | ||||||
| NSW | 3.32 | 3.28 | 4.08 | 2.30 | 3.55 | 835 |
| VIC | 3.49 | 3.20 | 4.40 | 2.68 | 3.63 | 748 |
| QLD | 3.44 | 3.24 | 4.43 | 2.44 | 3.45 | 467 |
| WA | 3.21 | 3.21 | 4.20 | 2.31 | 2.96 | 250 |
| SA | 3.32 | 3.26 | 4.02 | 2.43 | 3.55 | 230 |
| ACT | 3.19 | 2.89 | 4.15 | 2.33 | 3.74 | 27 |
| TAS | 3.43 | 3.23 | 4.36 | 2.46 | 3.79 | 71 |
| NT | 3.00 | 2.75 | 3.92 | 2.67 | 3.17 | 12 |
| Modified Monash Model | ||||||
| MM1 | 3.33 | 3.12 | 4.29 | 2.35 | 3.49 | 1653 |
| MM2 | 3.40 | 3.27 | 4.25 | 2.43 | 3.49 | 210 |
| MM3 | 3.29 | 3.32 | 4.04 | 2.24 | 3.52 | 229 |
| MM4 | 3.38 | 3.38 | 4.19 | 2.61 | 3.39 | 190 |
| MM5 | 3.67 | 3.64 | 4.25 | 2.97 | 3.70 | 318 |
| MM6 | 3.21 | 3.29 | 3.97 | 2.67 | 3.27 | 30 |
| MM7 | 3.40 | 3.30 | 4.20 | 3.40 | 3.60 | 10 |
| Modified Monash Model grouped | ||||||
| Metropolitan (MM1) | 3.33 | 3.12 | 4.29 | 2.35 | 3.49 | 1653 |
| Regional centres (MM2) | 3.40 | 3.27 | 4.25 | 2.43 | 3.49 | 210 |
| Rural and remote (MM3-7) | 3.47 | 3.47 | 4.16 | 2.67 | 3.55 | 777 |
Unrounded overall star rating
I calculated the unrounded overall star ratings according to the Star Ratings Provider Manual (Australian Government, Department of Health and Aged Care 2022). The overall star rating is usually calculated according to the formula, However, when the compliance star rating is two or lower, then the overall star rating can be no greater than the compliance rating. The unrounded star rating I use here simply stops after this step, whereas the official star ratings are rounded to the nearest whole number.
The distribution of unrounded overall star ratings, as calculated above, is shown in Figure 8. The densities at one stars were exclusively the result of the compliance rule. On the other hand, only some of the two stars were the result of the compliance rule, as shown in Figure 9.
It can be useful to look at the summary statistics for the unrounded overall star rating to understand differences between subgroups in the dataset. Table 7 presents a comprehensive view of unrounded overall star ratings, grouped by various strata, including a density plot and box plot for each.
| Min | Q1 | Median | Q3 | Max | Mean | SD | N | Density | Boxplot | |
|---|---|---|---|---|---|---|---|---|---|---|
| Home size | ||||||||||
| Small | 1.0 | 3.2 | 3.6 | 3.9 | 5.0 | 3.6 | 0.6 | 1120 | ||
| Medium | 1.0 | 3.0 | 3.3 | 3.6 | 4.7 | 3.3 | 0.5 | 845 | ||
| Large | 1.0 | 2.9 | 3.2 | 3.5 | 4.7 | 3.2 | 0.5 | 535 | ||
| Organisation type | ||||||||||
| Not for profit | 1.0 | 3.0 | 3.4 | 3.7 | 4.8 | 3.3 | 0.5 | 1441 | ||
| For profit | 1.0 | 3.0 | 3.3 | 3.6 | 4.7 | 3.3 | 0.5 | 844 | ||
| Government | 2.0 | 3.7 | 4.0 | 4.4 | 5.0 | 4.0 | 0.6 | 215 | ||
| State | ||||||||||
| NSW | 1.0 | 3.0 | 3.4 | 3.7 | 4.8 | 3.3 | 0.5 | 786 | ||
| VIC | 2.0 | 3.1 | 3.5 | 3.9 | 5.0 | 3.5 | 0.6 | 704 | ||
| QLD | 1.0 | 3.2 | 3.4 | 3.8 | 4.8 | 3.4 | 0.5 | 454 | ||
| WA | 1.8 | 2.9 | 3.2 | 3.6 | 4.5 | 3.2 | 0.5 | 243 | ||
| SA | 1.0 | 3.0 | 3.4 | 3.6 | 4.7 | 3.3 | 0.5 | 208 | ||
| ACT | 2.0 | 3.1 | 3.3 | 3.5 | 4.3 | 3.2 | 0.5 | 27 | ||
| TAS | 2.0 | 3.2 | 3.5 | 3.8 | 4.3 | 3.5 | 0.6 | 70 | ||
| NT | 2.0 | 2.5 | 2.7 | 3.2 | 4.0 | 2.9 | 0.7 | 8 | ||
| Modified Monash Model | ||||||||||
| MM1 | 1.0 | 3.0 | 3.4 | 3.7 | 4.7 | 3.3 | 0.5 | 1555 | ||
| MM2 | 2.0 | 3.0 | 3.4 | 3.8 | 4.7 | 3.4 | 0.6 | 202 | ||
| MM3 | 1.0 | 3.0 | 3.3 | 3.6 | 4.7 | 3.3 | 0.5 | 212 | ||
| MM4 | 1.0 | 3.1 | 3.4 | 3.8 | 4.8 | 3.4 | 0.6 | 184 | ||
| MM5 | 1.0 | 3.3 | 3.7 | 4.1 | 5.0 | 3.7 | 0.7 | 309 | ||
| MM6 | 2.0 | 2.6 | 3.3 | 3.9 | 4.4 | 3.2 | 0.8 | 28 | ||
| MM7 | 2.0 | 3.2 | 3.5 | 4.1 | 4.4 | 3.5 | 0.7 | 10 | ||
| Modified Monash Model grouped | ||||||||||
| Metropolitan (MM1) | 1.0 | 3.0 | 3.4 | 3.7 | 4.7 | 3.3 | 0.5 | 1555 | ||
| Regional centres (MM2) | 2.0 | 3.0 | 3.4 | 3.8 | 4.7 | 3.4 | 0.6 | 202 | ||
| Rural and remote (MM3-7) | 1.0 | 3.1 | 3.5 | 3.9 | 5.0 | 3.5 | 0.6 | 743 | ||
Star rating by provider
The following table contains the average star rating in each category grouped by providers. Each service’s individual star ratings can be viewed by expanding the provider rows. The unrounded column corresponds to the unrounded overall star rating as described earlier.
References
Anika Wells MP. 2023. “Star Ratings System Working to Improve Aged Care.”
Australian Government, Department of Health and Aged Care. 2022. “Star Ratings Provider Manual.” https://www.health.gov.au/resources/publications/star-ratings-provider-manual?language=en.
———. 2023. “Star Ratings Quarterly Data Extract – 2022-23 Financial Year – Quarter 2.”