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Objective: To compare the outcomes and costs of clustered domestic and standard Australian models of residential aged care.

Design: Cross‐sectional retrospective analysis of linked health service data, January 2015 – February 2016.

Setting: 17 aged care facilities in four Australian states providing clustered (four) or standard Australian (13) models of residential aged care.

Participants: People with or without cognitive impairment residing in a residential aged care facility (RACF) for at least 12 months, not in palliative care, with a family member willing to participate on their behalf if required. 901 residents were eligible; 541 consented to participation (24% self‐consent, 76% proxy consent).

Main outcome measures: Quality of life (measured with EQ‐5D‐5L); medical service use; health and residential care costs.

Results: After adjusting for patient‐ and facility‐level factors, individuals residing in clustered models of …