New tool measures health beyond recovery for older Australians

Older Australians make up nearly half of hospitalisations and more than half of total patient days, but health systems still struggle to answer a crucial question: does care actually improve people’s day-to-day quality of life? Clinical endpoints can show whether conditions stabilise, yet they rarely capture the lived experience of recovery—independence, social connection, emotional wellbeing, and the ability to return to meaningful activities.

A new Flinders University study is designed to fill this gap by creating the first quality-of-life (QoL) measure tailored specifically for Australians aged 65 and over receiving subacute care. Subacute services include rehabilitation delivered after illness or injury, supporting recovery and safer transitions either home or into ongoing care.

Led by Dr Jenny Cleland, the project targets a major evaluation blind spot. In many settings, older people’s priorities are treated as supplementary rather than central to how “quality” is defined. The study argues that preference-based QoL measurement—where outcomes are linked to what individuals value—can provide more comparable, decision-ready evidence than traditional assessments focused mainly on symptoms and function.

The research team will work with older Australians and health partners to develop, validate, and implement a preference-based QoL tool. Methodologically, the work starts with in-depth interviews to identify domains that matter most, then moves to testing with hundreds of participants in subacute care to refine the measure for reliability and real-world usability.

Importantly, this project extends earlier national work: the Quality of Life-Aged Care Consumers (QOL-ACC), now used across more than 2,700 residential aged care homes through the Australian Government’s National Aged Care Quality Indicator Program. By adapting the concept to healthcare and subacute pathways, the study aims to enable consistent monitoring across systems where older adults frequently move between hospital and aged care services.

Professor Julie Ratcliffe, a senior investigator, emphasises that person-centred metrics are essential in an ageing population. The ultimate goal is to embed the measure across hospitals and subacute care services so researchers, clinicians, and policymakers can track outcomes that reflect what older Australians themselves consider valuable.

The paper detailing the study protocol—titled “A new health economic measure for improving the health and wellbeing of older Australians in subacute care settings: a study protocol”—was published in BMC Geriatrics in 2026.

In a health landscape where resources are limited and needs are complex, the promise of preference-based QoL measurement is straightforward: align investment with care models that demonstrably improve lives, not just clinical indicators.