People with dementia have comparatively high rates of hospitalisation. Their relatively high casemix complexity contributes to longer hospital stays, which has an impact on their physical and mental state. Research shows that well-designed and targeted services have improved the quality of care for people with dementia. However, few studies have investigated patient outcomes using integrated information about health services and aged care provision at the regional level.
The Hospital Dementia Services Project aims to inform health practitioners, health and aged care policy makers and planners, and consumers of how system factors influence care outcomes for patients with dementia. It will achieve this by investigating the extent to which different types, mixes and levels of hospital-based aged care and dementia services are associated with patient outcomes (e.g. death, admission to residential aged care) while accounting for provision levels of community-based (i.e. non-hospital) aged care services.
This project is a mixed-methods study. The study population consists of patients aged 50 years and over who had at least one night in a New South Wales public hospital between 1 July 2006 and 30 June 2007, focusing on patients with dementia. The study involves:
- undertaking a survey of hospitals about their dementia and aged care services
- interviews at selected hospitals to obtain information about hospital- and community-based services and to facilitate knowledge exchange
- linking administrative data sets to obtain information about patient pathways through hospital(s) and post-discharge
- a desk audit of aged care service provision
- multilevel modelling to investigate the extent to which patient-, hospital- and regional-level factors influence outcomes for patients with dementia compared with patients without dementia.
An Expert Panel representing key stakeholders will review findings and provide input throughout the project.
Findings will result in recommendations about the types and features of hospital-based dementia and aged care services that produce better outcomes for patients with dementia. High stakeholder engagement will enhance the relevance and usefulness of the findings.