Fewer people eligible for aged care are entering residential services within three months of approval in the ACT, which recorded the lowest percentage of clients moving into a facility within that time frame.
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Of people approved for aged care in 2015-2016, 36.6 per cent entered a service within three months in the ACT, compared to a national average of 52 per cent, according to the Productivity Commission's report on government services released on Tuesday.
The ACT's figure was down from 39.7 per cent the previous year, and 48.4 per cent in 2013-2014, a decline mirrored nationally.
An ACT Government spokeswoman said clients may be choosing not to commence care immediately, or residential aged care beds may be unavailable, while Council on the Ageing ACT housing advisor Luke Coniston said they may be delaying while considering having home care and respite care instead.
A spokeswoman for Aged Care minister Ken Wyatt said increased availability of home care, restorative care and respite care delayed entry to residential care.
"Many people who receive a recommendation for residential care may also receive and take up a recommendation for a home care package, or they may simply choose not to take up residential care at that time.
"Consequently, a delay between the assessment and entering aged care does not necessarily mean that older people are waiting to access the services they need."
The ACT recorded the highest rate of hospital patient days used by people waiting for residential aged care, reaching 22.9 per 1000 days last year, more than double the national average of 10.
It had a relatively high proportion of aged care places - including home care - for elderly people. The number of residential places grew by 226, while occupancy rates fell 6 per cent.
However, Mr Coniston said the measure of aged care places per person applied only to elderly people from the territory.
"What this fails to take into account is that many working people in Canberra aged in their 50s and are still working are having to bring their older parents, typically aged in their 70s and 80s, to Canberra to live either in aged care facilities or in other supported accommodation arrangements," he said.
"We are observing this is causing a significant trend of elder people to Canberra from interstate in their 70s and 80s that could well explain the delays in accessing aged care services. It could also explain a significant amount of the pressure on the ACT Health System more broadly."
Government spending in the ACT on residential aged care and flexible care services was $2,593 per person in the sector's target population, the lowest in the country except for the Northern Territory, the Productivity Commission report found.
Spending reached $4,737 per person on all aged care services in total, the country's third highest figure, and $1,828 per person on home care and support services, more than other states and territories.
Mr Coniston said there was a greater need for spending on aged care services by both the ACT and federal governments.
"[They] need to ... do more not only to meet the needs of Canberra's internal ageing population, but to also meet the needs of the elderly people who are moving here from interstate to be close to their adult children who now have to work for longer."
The ACT government pointed to its residential aged care liaison nurse and its Rapid Assessment of the Deteriorating Aged at Risk service as ways it was assisting people entering care.
The ACT's older population is expected to triple in the next 40 years, and COTA ACT last year warned of undersupply and expense in the aged care sector.
