# NZIER — Assessing the Equity Issues Facing Aged Residential Care over the Coming Decade

15 July 2022 commissioned NZIER analysis of affordability, non-ORA beds, deprivation and regional access to aged residential care; historical evidence and explicit demographic scenarios, with an 85+ denominator and substantial data limitations.

## What this source contributes

This July 2022 NZIER report examines whether older people with limited financial resources will be able to access aged residential care as the population ages. It connects declining home ownership, deprivation, regional bed supply, ORA-funded accommodation and nursing shortages. Using historical NZACA/TAS bed data, Ministry of Health information and population projections, it shows how aggregate capacity can conceal gaps in non-ORA beds and regional access. A fixed-bed scenario lowers national non-ORA bed coverage relative to the population aged 85+ from 40% in 2022 to 29% in 2030; it is an assumption-based illustration, not an observed shortage or individual likelihood of admission. The analysis was commissioned by Aged Care Matters and uses former DHB geographies, older cost/subsidy settings and international measures with differing coverage. It is useful historical equity evidence, not a current bed directory, subsidy guide or independent facility audit.

## Contents and page references

- Cover, authorship, key points and contents (physical pp.1–5)
- Background, care funding, provider models and data geography (physical pp.6–11 / printed pp.1–6)
- Housing affordability, international long-term-care comparisons and demography (physical pp.12–17 / printed pp.7–12)
- Non-ORA and dementia beds, occupancy, deprivation and access risks (physical pp.18–23 / printed pp.13–18)
- Discussion, conclusions and references (physical pp.24–27 / printed pp.19–22)
- Appendix: quarterly regional bed and occupancy charts, 2015–2022 (physical pp.28–30 / printed pp.23–25)

## Substantive findings

- The cover dates the report 15 July 2022 and names Aged Care Matters as commissioner; Philippa Miller Moore and Christina Leung prepared it. The preserved original has 30 physical pages, not 19. The checked author-produced PDF hosted by Scoop is byte-identical; a current NZIER-hosted copy was not located (physical pp.1 and 3).
- The report distinguishes care beds financed through an occupation right agreement (ORA) from non-ORA beds. Increasing ORA accommodation may not meet the needs of people without the capital to purchase it; total bed counts therefore do not establish equitable access (physical pp.8–9 / printed pp.3–4).
- Figure 8 assumes no new investment and no significant reduction in beds. Non-ORA beds relative to the 85+ population fall from 40% in 2022 to 29% in 2030 under that assumption; maintaining 40% would require an increase from 36,402 to 52,224 beds, or 43%. This is bed inventory divided by the 85+ population, not occupancy or the percentage of all older people needing care (physical p.20 / printed p.15).
- Regional analysis uses former DHB boundaries and 2015–March 2022 quarterly bed/occupancy series. The 2022 health-system reorganisation is part of the report’s context; these boundaries and figures are not a current inventory of operational or staffed beds (physical pp.10–11, 18–20 and 28–30).
- The deprivation overlay uses NZDep2018 quintiles 4 and 5 and assumes each region’s deprived share of its 85+ population stays constant from 2018 to 2040. It identifies West Coast, Northland, MidCentral, Whanganui and Tairāwhiti as access-risk areas; it does not measure current individual income, unmet need or admission refusals (physical pp.17 and 23 / printed pp.12 and 18).
- The report warns that focusing on people aged 85+ may underestimate Māori and Pacific aged-care needs because of lower life expectancy. Its denominator is an analytical proxy, not a clinical assessment or an age-based exclusion rule (physical p.15 / printed p.10).
- Nursing shortages can make certified beds unusable. The report cautions that apparently low occupancy may reflect unavailable staff and that regional bed classifications are inconsistent; recorded beds are not necessarily capacity a family can access (physical pp.8 and 24–25 / printed pp.3 and 19–20).
- International long-term-care spending comparisons include different populations and services, may rely on old estimated New Zealand data, and exclude unpaid care. Historical 2021/22 contribution and asset-test figures are contextual and were not verified as current eligibility guidance (physical pp.7 and 13–14 / printed pp.2 and 8–9).
- The accessible NZACA page Supporting equitable and timely access to aged residential care is a different July 2022 interRAI-based report. Its 5 July release date must not be assigned to this NZIER report. The legacy NZACA PDF URL was not reliably retrievable during this review.

## Practical use

Use this historical analysis to ask whether planned beds will be affordable, staffed, culturally appropriate and available in the regions where need is growing. Keep ORA and non-ORA capacity separate, preserve each demographic denominator, and update local supply, deprivation and workforce evidence before drawing present-day conclusions.

Recommended readers:

- Residents and whānau advocates exploring affordable care options
- Aged-care commissioners and equity researchers
- Providers planning staffed, affordable regional capacity

## Consumer implications

- Ask providers about non-ORA options, actual staffed vacancies and additional accommodation charges. The report cannot establish today’s availability or your subsidy eligibility.
- A population aged 85+ comparison does not determine an individual’s care needs; seek a current needs assessment and financial assessment through the appropriate official services.

## Policy implications

- Evaluate operational, affordable capacity rather than relying on aggregate certified beds; regional and cultural needs can differ from an 85+ population proxy.
- Refresh assumptions about deprivation, home ownership, demand and workforce supply before reusing the 2030 fixed-bed scenario. Commissioned advocacy context and inconsistent source classifications remain relevant limits.

## Provider and business implications

- Distinguish ORA-funded developments from non-ORA access and test staffing, affordable accommodation and regional demand separately. Historical bed ratios and international spending comparisons are not current investment forecasts or price benchmarks.

## Source, dates and evidence boundary

Commissioned NZIER economic analysis dated 15 July 2022, with 30 original physical pages extracted and reviewed, cover/scenario images checked, and the author-produced Scoop-hosted PDF byte-matched. A stable current NZIER/commissioner download was not established; legacy commissioner access differed between browsing and direct retrieval. A similarly titled 5 July NZACA interRAI report is distinct. Historical data use former DHB regions, 2015–March 2022 bed series, NZDep2018, population projections and older international evidence. The 40%–29% comparison is non-ORA beds divided by population aged 85+ under a fixed-bed assumption, not observed unmet need, occupancy, a prediction of admission or an entitlement. Deprivation shares are held constant and the report warns its age proxy can understate Māori/Pacific need. Certified beds may be unstaffed and classifications inconsistent. The commissioner’s advocacy purpose, costs, clinical/causal claims, subsidy rules and international comparability were not independently or comprehensively validated for current use. Report date, PDF production, mirror upload path, June 2026 capture/access and 10 October 2026 review are separate; original file, category and hash are preserved.

- Original file: `2022 - NZIER - Assessing Equity Issues Facing ARC.pdf`
- Source publication/report date: 2022-07-15
- Original capture/access label retained: June 2026
- Primary evidence reviewed: 10 October 2026
- Next review: 10 April 2027
- Preserved original: [Download PDF](/pdfs/2022%20-%20NZIER%20-%20Assessing%20Equity%20Issues%20Facing%20ARC.pdf)
- Primary source: [Publisher/report source](https://img.scoop.co.nz/media/pdfs/2208/NZIER_Report_for_Aged_Care_Matters.pdf)
- Reconciliation fixture: `artifacts/research/arc-equity-budget-source-audit-2026-10-10.json`

## Verification and source links

- Preserved original: 1,030,927 bytes; 30 physical pages.
- SHA-256: `50dee24ecb28ac35e7d48fba5ac348ddda1bcf2da5541003b84439bb6bf52f41`.
- Original PDF unchanged; current checked PDF aliases match these bytes.

- [Byte-identical author-produced report attachment (Scoop mirror)](https://img.scoop.co.nz/media/pdfs/2208/NZIER_Report_for_Aged_Care_Matters.pdf)
- [Distinct NZACA interRAI equitable-access report — identity check only](https://nzaca.org.nz/news/equitable-access-to-arc-report/)