24. Hospital use by older Australians

In Australia in 1993 - 94 there were 702 public and 329 private acute and psychiatric hospitals. In 1995 - 96 Australia had a rate of 283 hospital separations per 1,000 persons, a rate higher than for the other OECD countries for which data were available. These higher rates are largely attributed to the inclusion of same-day admissions in the Australian data, which results in a comparatively short average length of stay (the lowest among OECD countries reporting length of stay).

Older Australians account for a large number of hospital separations. They have a higher rate of admission to hospital than the general population, and tend to stay longer. In 1995 - 96 patients aged 65 and over accounted for 1.5 million hospital separations (30% of all separations) and 11 million patient days (48% of all patient days). While older men and older women accounted for roughly equal numbers of separations (763,600 and 772,600), women predominated in terms of patient days (4,864,300 for men and 6,306,400 for women). This reflects the larger proportion of women than men in the older population, particularly at more advanced ages where length of stay tends to be longer.

Given the relatively small proportion of older people in Australia (12%) and their substantially different age structure, hospital separations and patient days per 1,000 population provide a better indication of relative rates of hospital use than do absolute numbers of separations and patient days. Hospital use is greater among older persons than the general population; the number of separations per 1,000 persons aged 65 and over was 706, compared to an overall rate of 284 for the total population. For both males and females separation rates increased markedly with age, particularly for males. While separation rates were higher for females than for males in the general population (due in part to higher rate of admissions among women for reproductive health care), a different trend emerged amongst the older population. Older men had higher rates of hospital separations than older women, with these differences most prominent amongst the very old (85 and over age group). Separation rates increased at older ages for both men and women.

Similarly, older men accounted for a larger number of patient days per 1,000 population than did older women at any given age, and these rates again increased with age for both men and women. However, the older average age of women in comparison to men results in a situation where total patient day usage rates per 1,000 of the population were quite similar for older men and older women (5,136 and 5,126).

Older patients generally stay longer in hospitals, on average 7.3 days compared to 4.5 days for all age groups. Older women had longer average lengths of stay in hospital than older men, 8.2 days on average compared with 6.4 days. As was the case for both separations and patient day rates per 1,000 of the population, average length of stay increased with age for older patients, especially for women. The differences between men and women were most marked amongst the very old, with men aged 85 and over on average staying for 11 days in hospital compared to 14 days for women of the same age group.

Patients aged 65 and over; hospital separations and patient days by age and sex, Australia 1995 - 96

Patients aged 65 and over; average length of stay (days) by age and sex, Australia 1995 - 96

References/further reading

Australian Institute of Health and Welfare 1996. Australia's health 1996: the fifth biennial report of the Australian Institute of Health and Welfare. Canberra: Australian Government Publishing Service (AGPS).

Australian Institute of Health and Welfare 1997. Australian hospital statistics 1995 - 96. Health Services Series No. 10. Canberra: AGPS.

Data sources