Hospitalisations due to or with dementia
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The previous page presented hospitalisations due to dementia (that is, when dementia was recorded as the principal diagnosis), but understanding hospitalisations due to or with dementia provides important insights on the wide-ranging conditions that can lead people living with dementia to use hospital services. See Box 9.1 for key terms related to hospitalisations for people with dementia.
Box 9.3: Key terms for hospitalisations related to dementia
The following terms are used to distinguish dementia hospitalisations:
- Hospitalisations due to dementia are hospitalisations where dementia was recorded as a principal diagnosis (the main reason for admission).
- Hospitalisations with dementia are hospitalisations where dementia was recorded as an additional diagnosis (where dementia impacted the hospitalisation but was not the main reason for admission), or where dementia was recorded as a ‘supplementary code’ (when dementia is identified as a chronic condition that is part of a patient’s current health status), and was not recorded as a principal diagnosis.
- Hospitalisations due to or with dementia are hospitalisations where dementia was recorded as a principal diagnosis and/or an additional diagnosis (where dementia impacted the hospitalisation but was not the main reason for admission), or where dementia was recorded as a ‘supplementary code’ (when dementia is identified as a chronic condition that is part of a patient’s current health status).
Trends in hospitalisations due to or with dementia
When accounting for all possible inclusions of dementia codes in a patient record, in 2023–24, there were just under 217,000 hospitalisations due to or with dementia (105,000 for men and 112,000 for women; Table S9.9). This is equivalent to almost 1 out of every 58 hospitalisations in Australia.
Between 2015–16 and 2023–24, there was a 35% increase in the number of hospitalisations due to or with dementia, and a 7% increase in the rate of hospitalisations due to or with dementia (Figure 9.4).
For men, the rate of hospitalisations due to or with dementia tended to steadily increase between 2015–16 and 2023–24. For women , the rate of hospitalisations due to or with dementia decreased slightly between 2018–19 and 2021–22 before increasing again between 2021–22 and 2023-24. Similar patterns were observed for the age-standardised rates.
Figure 9.4: Hospitalisations due to or with dementia by sex: number, crude rate and age-standardised rate, between 2015–16 and 2023–24
This figure displays three line graphs presenting the estimated number, crude rate and age-standardised rates of hospitalisations with dementia in Australia by sex between 2015–16 and 2023–24. Distinct patterns are explained in the previous paragraph.
Notes
- The age-standardised rates were standardised to the Australian population as at 30 June 2001 and are expressed per 10,000 population.
- Rates apply to the population aged 60 and over.
- Hospitalisations with dementia include all hospitalisations with a record of dementia, whether as the principal and/or an additional diagnosis and/or supplementary diagnosis.
Box 9.4: Potential factors impacting hospitalisations with dementia over time
In July 2015, 29 supplementary codes for chronic conditions (including dementia) and a new Australian Coding Standard were implemented in existing classification systems and coding rules for assigning specific codes to diagnoses found in medical records (ACCD 2015). As a result, from July 2015 onwards dementia can be recorded in hospital data using a supplementary code when it does not meet the criteria to be recorded as a principal or additional diagnosis.
The introduction of supplementary codes in 2015 has impacted the recording of a few chronic conditions as an additional diagnosis in hospitals data, especially in cases where the chronic disease does not directly impact the care provided to the patient. There was an observable decrease in the yearly proportion of hospitalisations with an additional diagnosis of dementia in 2015 that has remained stable since (AIHW 2023).
What were the most common principal diagnoses when dementia was an additional diagnosis?
In 2023–24 there were just over 189,000 hospitalisations where dementia was recorded as an additional diagnosis (hospitalisations with dementia). Examining the most common principal diagnoses recorded for these hospitalisations provides insights on the diverse reasons why people living with dementia require hospital services. The most common principal diagnoses were:
- Problems related to medical facilities and other health care, ICD-10-AM codes Z75.0–9 (13,600 hospitalisations or 7.2% of hospitalisations where dementia was an additional diagnosis). These hospitalisations are where patients are required to stay in hospital longer to rehabilitate or are waiting to transfer to new accommodation. These hospitalisations may be counted as a separate hospitalisation rather than a continuation of a hospitalisation from an acute episode (such as a fracture)
- Fracture of the femur, ICD-10-AM codes S72.0–9 (7,800 hospitalisations or 4.1%)
- Other disorders of urinary system (including urinary tract infection), ICD-10-AM code N39 (6,600 hospitalisations or 3.5%)
- Pneumonitis due to solids and liquids, ICD-10-AM code J69 (5,200 hospitalisations or 2.8%) (Figure 9.5).
Other common principal diagnoses recorded for these hospitalisations included pneumonia, delirium not induced by alcohol and other psychoactive substances, COVID-19, heart failure and sepsis (Table S9.10).
Falls
Falls (ICD-10-AM codes W00–W19) accounted for 96% of all hospitalisations due to fractures of the femur, and 94% of hospitalisations due to fractures of the lumbar spine and pelvis, where dementia was an additional diagnosis. Women had twice as many hospitalisations than men for a fracture of the femur and fracture of the lumbar spine and pelvis, with an additional diagnosis of dementia (Table S9.11).
Figure 9.5: Most common principal diagnoses where dementia was an additional diagnosis, by sex, in 2023–24
A bar graph showing the number of hospitalisations for the most common principal diagnoses when dementia was recorded as an additional diagnosis, by sex in 2023–24. Distinct patterns are explained in the previous paragraphs.
ACCD (The Australian Consortium for Classification Development) (2015) Reference to Changes for ICD-10-AM/ACHI/ACS 9th edn, Independent Hospital Pricing Authority, Australian Government, accessed 17 August 2022.
AIHW (Australian Institute of health and Welfare) (2023) Supplementary codes for chronic conditions: evaluation report for population health monitoring, AIHW, Australian Government, accessed 25 July 2024.