Hospital care for Indigenous Australians with dementia

In 2018–19, there were 269 hospitalisations due to dementia (that is, dementia was the principal diagnosis or the main reason for their hospital admission) where the patient identified as an Indigenous Australian.

Indigenous men were more likely to be hospitalised due to dementia (25 hospitalisations per 10,000 Indigenous Australians) than Indigenous women (20 per 10,000 Indigenous Australians) (Figure 12.4).

See Hospital care for more information on overall hospitalisations for dementia in Australia and the Technical notes for more information on hospitals data. For information about the quality of Indigenous identification in hospitals data, see the following AIHW report Indigenous identification in hospital separations data: quality report.

Figure 12.4: Hospitalisations due to dementia in 2018–19: age-standardised rate, by sex

Figure 12.4 is a bar graph showing the age standardised rate of hospitalisations due to dementia for male and female Indigenous Australians in 2018–19. For every 10,000 Indigenous men, there were 25 hospitalisations due to dementia whereas for Indigenous women there were 20 hospitalisations due to dementia per 10,000 Indigenous women.

Visualisation not available for printing

The average length of stay among Indigenous Australians for hospitalisations due to dementia was 12.5 days, similar to the average length of stay for hospitalisations due to dementia in 2018–19 for all Australians (13 days).

There are many reasons why Indigenous Australians may not want to use hospital services, such as: competing family and cultural obligations; distrust in the health system due to negative past and present experiences; a lack of culturally safe care options; communication barriers with medical staff, including barriers for Indigenous Australians for whom English is a second language; limited access to health services in regional and remote locations requiring patients to receive care away from their community; high travel and other out-of-pocket costs, especially for people living in regional and remote locations (AHMAC 2017; Shaw 2016).

How did hospitalisations due to dementia for Indigenous Australians vary by geographic area?

Given the small number of hospitalisations due to dementia for Indigenous Australians in a given year, the rate of hospitalisations due to dementia presented in this section was aggregated over a 3-year period (2016–17, 2017–18 and 2018–19).

After adjusting for population differences, between 2016–17 and 2018–19, the age-standardised rate of hospitalisations due to dementia for Indigenous Australians aged 40 and over, was:

  • highest in Queensland (29 hospitalisations per 10,000 Indigenous Australians) closely followed by the Northern Territory and Western Australia (28 and 27 hospitalisations per 10,000 Indigenous Australians, respectively), and was lowest in Victoria and New South Wales (17 and 19 hospitalisations per 10,000 Indigenous Australians, respectively) 
  • highest in Remote and very remote areas (29 hospitalisations per 10,000 Indigenous Australians) closely followed by Major cities (27 hospitalisations per 10,000 Indigenous Australians), and was lowest in Inner and outer regional areas (17 hospitalisations per 10,000 Indigenous Australians) (Figure 12.5).

Figure 12.5: Hospitalisations for Indigenous Australians due to dementia between 2016–17 and 2018–19: age-standardised rate, by state and territory and remoteness area

Figure 12.5 is a bar graph showing the age standardised rate of hospitalisations due to dementia among Indigenous Australians between 2016–17 and 2018–19 by remoteness area and state or territory. The rates of hospitalisation due to dementia for Indigenous Australians were highest in Remote and very remote areas, Major cities, Queensland, Northern Territory and Western Australia.

Visualisation not available for printing

What were the most common principal diagnoses for Indigenous Australians when dementia was an additional diagnosis?

The statistics presented in the previous section relate to hospitalisations due to dementia, which are those where dementia was the principal diagnosis or main reason for hospitalisation. However, hospitalisation data also include information relating to ‘additional diagnoses’, which are those conditions that impact the provision of care but are not the principal diagnosis. 

In 2018–19 there were 1,365 hospitalisations with dementia among Indigenous Australians.

When dementia was an additional diagnosis, the most common principal diagnoses among hospitalisations among Indigenous Australians aged 40 and over were:

  • Problems related to medical facilities and other health care—15 hospitalisations per 10,000 Indigenous Australians
    • the majority of these hospitalisations (83%) related to people awaiting admission to residential aged care services
  • Fracture of the femur—11 hospitalisations per 10,000 Indigenous Australians
  • Pneumonia, organism unspecified—10 hospitalisations per 10,000 Indigenous Australians.

Other common principal diagnoses recorded for these hospitalisations included urinary system disorders, sepsis and a number of chronic conditions such as chronic obstructive pulmonary disease, cardiovascular diseases, and diabetes (Figure 12.6).

Indigenous men were more likely than Indigenous women to have a principal diagnosis of Acute myocardial infarction (20 hospitalisations per 10,000 for men compared with 6.4 per 10,000 for women), Other chronic obstructive pulmonary disease (11 per 10,000 for men compared with 6.5 per 10,000 for women) and Type 2 diabetes mellitus (6.9 per 10,000 for men compared with 2.6 per 10,000 for women). In contrast, Indigenous women were more likely than men to have a principal diagnosis of Fracture of the femur (25 per 10,000 for women compared with 7.2 per 10,000 for men), Other sepsis (18 hospitalisations per 10,000 for women compared with 4.9 per 10,000 for men) and Pneumonitis due to solids and liquids (14 per 10,000 for women compared with 4.1 per 10,000 for men).

Figure 12.6: Common principal diagnoses for hospitalisations of Indigenous Australians where dementia was an additional diagnosis in 2018–19: age-standardised rate, by sex

Figure 12.6 is a bar chart showing the age standardised rates of hospitalisations by common principal diagnoses and sex for Indigenous Australians where dementia was an additional diagnosis in 2018–19. Overall, the most common principal diagnosis was problems related to medical facilities and other health care, followed by fracture of femur and pneumonia, organism unspecified. There were substantial differences by sex across the principal diagnoses. For example, men with an additional diagnosis of dementia had higher rates of hospitalisation due to acute myocardial infraction, other COPD and type 2 diabetes mellitus while women had higher rates of hospitalisations due to fracture of femur, other sepsis and pneumonitis due to solids and liquids.

Visualisation not available for printing