Hospital care for Indigenous Australians with dementia

In 2020–21, there were 375 hospitalisations due to dementia (where dementia was the principal diagnosis or the main reason for their hospital admission) where the patient identified as an Indigenous Australian.

Indigenous women were more likely to be hospitalised due to dementia (32 hospitalisations per 10,000 Indigenous women) than Indigenous men (28 hospitalisations per 10,000 Indigenous men) (Figure 12.9).

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

Figure 12.9: Hospitalisations for Indigenous Australians due to dementia in 2020–21: age-standardised rate, by sex

Figure 12.9 is a bar graph showing the age standardised rate of hospitalisations due to dementia for male and female Indigenous Australians in 2020–21. For every 10,000 Indigenous women, there were 32 hospitalisations due to dementia whereas for Indigenous men there were 28 hospitalisations due to dementia per 10,000 Indigenous men.

The average length of stay among Indigenous Australians for hospitalisations due to dementia was 14.6 days, slightly higher than the average length of stay for all hospitalisations due to dementia in 2020–21 for non-Indigenous Australians (12.7 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 rates of hospitalisations due to dementia presented in this analysis were aggregated over a 3-year period (2018–19, 2019–20 and 2020–21).

After adjusting for population differences, between 2018–19 and 2020–21, the age-standardised rate of hospitalisations due to dementia for Indigenous Australians aged 40 years and over, was:

  • highest in Queensland, Western Australia and Northern Territory (each 32 hospitalisations per 10,000 Indigenous Australians) closely followed by South Australia (28 hospitalisations per 10,000 Indigenous Australians), and was lowest in Victoria and New South Wales (23 and 24 hospitalisations per 10,000 Indigenous Australians, respectively) 
  • highest in Remote and very remote areas (32 hospitalisations per 10,000 Indigenous Australians) closely followed by Major cities (30 hospitalisations per 10,000 Indigenous Australians) and was lowest in Inner and outer regional areas (22 hospitalisations per 10,000 Indigenous Australians) (Figure 12.10).

Figure 12.10: Hospitalisations for Indigenous Australians due to dementia between 2018–19 and 2020–21: age-standardised rate, by state and territory and remoteness area

Figure 12.10 is a bar graph showing the age standardised rate of hospitalisations due to dementia among Indigenous Australians between 2018–19 and 2020–21 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.

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

Previous sections have presented hospitalisations due to dementia (that is, when dementia was recorded as the principal diagnosis), but understanding hospitalisations with dementia (that is all hospitalisations with a record of dementia, whether as the principal and/or an additional diagnosis) provides important insights on the wide-ranging conditions that can lead people living with dementia to use hospital services. In 2020–21 there were 1,234 hospitalisations of Indigenous Australians with dementia.

The most common principal diagnoses among hospitalisations for Indigenous Australians aged 40 years and over, where dementia was an additional diagnosis, were:

  • Problems related to medical facilities and other health care (11.3%)
  • Delirium, not induced by alcohol and other psychoactive substances (6.5%)
  • Other disorders of urinary system (4.2%)

Other common principal diagnoses recorded for these hospitalisations included sepsis, femur fractures and a number of chronic conditions such as chronic obstructive pulmonary disease, cardiovascular diseases, and diabetes (Figure 12.11).

Indigenous men were more likely than Indigenous women to have a principal diagnosis of Pneumonitis due to solids and liquids (5% of hospitalisations for men compared with 1.6% for women), Pneumonia, organism unspecified (3.3% of hospitalisations for men compared with 1.7% for women) and Type 2 diabetes mellitus (3.1% of hospitalisations for men and 1.6% for women). In contrast, Indigenous women were more likely than men to have a principal diagnosis of Other disorders of urinary system (5.4% of hospitalisations for women compared with 2.4% for men), Fracture of femur (4.2% of hospitalisations for women compared with 2.0% for men) and Heart failure (2.5% of hospitalisations for women and 0.9% for men).

Figure 12.11: Common principal diagnoses for hospitalisations of Indigenous Australians where dementia was an additional diagnosis in 2020–21: percent of hospitalisations, by sex

Figure 12.11 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 2020–21. Overall, the most common principal diagnosis was problems related to Medical facilities and other health care, followed by Delirium, not induced by alcohol and other psychoactive substances, and Other disorders of the urinary system. There were substantial differences by sex across the principal diagnoses. For example, men with an additional diagnosis of dementia had higher rates of Pneumonitis due to solids and liquids, Pneumonia, organism unspecified and Type 2 diabetes mellitus, while women had higher rates of hospitalisations due to Other disorders of the urinary system, Fracture of femur and Heart failure.