This report estimates the cost of dementia care in New South Wales public hospitals using a subset of data from the Hospital Dementia Services (HDS) Project conducted by the Australian Institute of Health and Welfare in conjunction with the University of New South Wales and the University of Canberra. New South Wales provides both system and population diversity to be broadly representative of the Australian hospital experience of people with dementia. The report also presents innovative strategies and practices being implemented in Australia and internationally, which might improve the quality and cost efficiency of dementia care in hospitals.
Almost half (47%) of episodes for people with dementia did not have dementia recorded as a diagnosis
The study population includes 20,748 people with dementia who had a completed hospital stay including at least one night in a New South Wales public hospital in 2006-07.
Identification and reporting of dementia is often poor in hospitals-for almost half of the episodes for people with dementia in this study, dementia was not recorded as either a principal or additional diagnosis.
People with dementia generally stay in hospital longer and have higher associated costs of care
Results from this study showed that people with dementia generally have a longer length of stay (LOS) within a hospital than other patients, leading to greater costs to the health system. Almost three-quarters of the reasons for hospital care included in this study involved a longer median LOS for people with dementia compared with people without dementia. The average cost of hospital care for people with dementia was higher than for people without dementia ($7,720 compared with $5,010 per episode, respectively). The total cost of care in New South Wales public hospitals for patients who had dementia in 2006-07 was estimated to be $462.9 million, of which around 35% ($162.5 million) may be associated with dementia.
A range of strategies were identified that could improve outcomes for people with dementia and reduce the costs of care
General strategies that might improve outcomes for people with dementia in hospitals were identified through a literature review, HDS site visits and the expert advisory group for this report. This review highlighted a number of different initiatives being implemented in a range of settings, including strategies outside the hospital, strategies within emergency departments, strategies within the hospital, cross-sectoral strategies and environmental strategies.
All of these strategies are ultimately aimed at improving the care experience for people with dementia. The findings of the review of strategies suggest that a multifaceted and integrated approach between hospital, mental health, residential aged care and community services is most likely to ensure that dementia care is delivered in the most appropriate and beneficial setting for the patient.
Preliminary pages: Foreword; Acknowledgments; Abbreviations
- Identifying the costs of hospital care
- Identifying strategies affecting hospital use
- Structure of report
Cost of dementia care in hospital – methods
- Hospital Dementia Services (HDS) Project
- Costing estimation method
Cost of dementia care in hospital – results
- Under-identification of dementia
- Costing hospital episodes of care
- Costing hospital lengths of stay
Strategies and practices affecting hospital use – methods
- Literature review methods
- Hospital Dementia Service Project fieldwork methods
Strategies and practices affecting hospital use – results
- Strategies outside the hospital
- Strategies within emergency departments
- Strategies within the hospital
- Cross-sectoral strategies
- Environmental strategies
Appendix A: Literature review strategies
Appendix B: Data quality statement
End matter: References; List of tables; List of figures; List of boxes