The Burrow
Mar 26, 2026
Identifying the best states for elderly care is becoming increasingly important as populations continue to age in both Australia and the United States. With people living longer than ever before, understanding life expectancy by state, healthcare access and nursing home quality ratings highlights where older people receive the strongest support. However, the quality of care available in a nursing home or wider healthcare system can vary significantly depending on where someone lives.
As experts in health insurance comparison, Compare the Market has analysed regions across Australia and the US to determine the best states for elderly care by creating a Senior Healthcare Quality Index. It was built using publicly available data across three areas: health status, healthcare quality, and access and experience. Metrics include demographic context such as the proportion of residents aged 65+ and life expectancy by state, alongside healthcare quality indicators and nursing home quality ratings.
Each factor was then indexed and combined into a score out of 100, allowing regions to be ranked based on how well they support ageing populations.
Our analysis of the elderly care landscape in Australia evaluates healthcare performance, aged care standards and patient outcomes across several key indicators. These include unplanned hospital readmission rates, elective surgery waiting times, emergency department waiting times, potentially preventable hospitalisations, nursing home quality ratings, resident experience scores and health workforce growth.
New South Wales ranks first overall, with 65.3% of care home residents’ experiences ranked 4 stars or above. Consistent healthcare performance across many other measures positions NSW as the best state for elderly care in Australia.
The Australian Capital Territory ranks second, supported by the highest life expectancy by state at 84.1 years and strong health workforce growth per capita. These factors contribute to strong healthcare access and positive care outcomes for older residents.
Victoria places third, partly due to a net growth in the health workforce of 496.1 per 100,000 of the population. Stable results across hospital performance and nursing home care standards also contribute to its strong ranking among the best states for elderly care.
Queensland ranks fourth, performing particularly well for hospital access. The state records the highest rate of elective surgery admissions within clinically recommended time (77.7%) and strong emergency department performance with an average wait time of 91 minutes, which is the lowest out of all eight regions.
Western Australia completes the top five, supported by a strong life expectancy by state of 83.7 years and balanced results across healthcare quality measures and nursing home quality ratings.
While several regions perform strongly, others face greater challenges in supporting ageing populations. The following states and territories recorded the lowest scores in our index, reflecting regional variation in healthcare access, hospital performance and nursing home quality ratings.
South Australia records the lowest overall index score. This is due to factors that include the highest waiting time for emergency department care, at 212 minutes, and the lowest result for residents’ experience in care homes at just 20.6% ranking them 4 stars or above.
Tasmania ranks second from the bottom, recording the lowest health workforce growth (410.1 per 100,000 of the population). This significantly influences the availability and accessibility of care for older residents.
The Northern Territory records the lowest life expectancy by state at 78.4 years (the only state under 80) and faces challenges across hospitalisation rates and healthcare access. This reflects regional variation in healthcare infrastructure and service availability.
Across the United States, the index highlights several states that perform particularly well for elderly healthcare support, combining strong nursing home quality ratings, healthcare access and positive health outcomes.
Idaho ranks first as the best state for elderly care in the US, performing strongly across patient experience, provider access and nursing home care standards. This is partly thanks to a life expectancy of 78.4 years and the average patient experience being relatively high at 67.9%.
Hawaii ranks second, in part due to having the highest life expectancy by state at 80 years. It also scores highly (59.7%) for nursing home quality ratings.
North Dakota places third, leading in the US for nurse availability with 223.6 registered nurses per 100,000 citizens. This strong workforce capacity and hospital performance contribute to its high ranking.
Utah ranks fourth due to a life expectancy of 79 years and an average of 67% for patient experience. This reflects strong performance across healthcare access and nursing home quality ratings, supporting consistent care for older residents.
Arkansas rounds out the top five. Despite a lower life expectancy by state (73.9 years) compared with some other leading states, its relatively strong nursing home quality (36.4%) supports its high position in the ranking.
At the other end of the ranking, several states record lower overall scores in the index. These regions tend to show greater variation across healthcare access, workforce availability and nursing home care standards, illustrating how elderly care provision can differ across the country.
Nevada records the lowest score in the index, with weaker results across nursing home quality ratings, healthcare affordability and workforce availability. Here, patient experience is just 62.9% and 11.5% of hospital visits are unplanned.
New Mexico ranks second from the bottom. This is partly due to there being just 100.5 advanced practice registered nurses per 100,000 of the population, as well as relatively high levels (5%) of people aged 65+ avoiding care due to cost.
Illinois records variation across multiple healthcare metrics. For instance, the life expectancy here is quite high at 77.5 years, but nursing home quality stands at just 21.7%.
Pennsylvania ranks fourth from the bottom and shows an average of 11.7% unplanned hospital visits among its population of over 13 million people.
Oklahoma rounds out the bottom five, with a life expectancy of 73.8 years and only 100.4 advanced practice registered nurses per 100,000 of the population.
Steven Spicer, Executive General Manager of Health, Life and Energy at Compare the Market, says:
“Planning for later life is becoming increasingly important as populations age and people live longer. For many people, reviewing healthcare options, including private health insurance, can provide greater certainty around access to care and support as their needs change over time.”
To assess how well regions support older adults, we built a Senior Healthcare Quality Index for US states and Australian states/territories. This index combines publicly available, region-level data across three key areas: health status, care quality, and access and experience.
First, we accounted for the size and health context of senior populations by including the proportion of citizens aged 65+ and life expectancy at birth. These provide essential context for comparing regions with different demographic profiles.
For healthcare performance, we drew on official quality measures:
In the US, this includes patient experience surveys, unplanned hospital visit rates, advanced practice nurse density, and indicators of avoided care due to cost. We also incorporated detailed nursing home quality measures such as overall ratings, staffing metrics and complaint histories from CMS data.
In Australia, hospital performance was captured through unplanned readmission rates, waiting times for elective surgery and emergency care, and potentially preventable hospitalisation rates, sourced from the Australian Institute of Health and Welfare. Care home quality was assessed via national star ratings and residents’ experience where available.
Each factor’s data was collected and ranked and indexed against all locations giving it a score between 0 and 100. If data was missing, a score of 0 was given. These scores were then combined to give each location a total score, with a higher scoring indicating a well performing location.
Key Metrics Used in the Study:
Source: US Census Bureau, Australian Bureau of Statistics.
Source: CDC – State Life Expectancy (USA), AIHW – Australia’s Health Performance (Australia).
Source: CMS – Patient Experience Data (USA).
Source: CMS – Unplanned Visits (USA).
Source: HRSA – Health Workforce Explorer (USA).
Source: Americas Health Rankings – Nursing Home Quality (USA).
Source: Americas Health Rankings – Cost Burden (USA).
Source: AIHW – Elective Surgery Data (Australia).
Source: AIHW – Preventable Hospitalisations (Australia).
Source: Health.gov.au – Care Home Ratings (Australia), Americas Health Rankings – Nursing Home Quality (USA).