Summary
The Hospital Dementia Services Project is an innovative study that uses linked data to explore how hospital-based aged care and dementia services in New South Wales in 2006-07 influenced outcomes for people with dementia.
This bulletin examines the hospital experiences of the 252,700 people aged 50 and over who stayed for at least one night in a New South Wales public hospital in 2006-07. All hospital stays that ended in 2006-07 are included to allow a complete analysis of patients' hospital care, comprising 408,500 multi-day stays and 252,400 same-day stays. Data for this analysis are person-based hospital stay data that allow both patient-level and stay-level analyses of hospital use by people with and without dementia.
Slightly more than 8% of patients (20,800 people) were identified as having dementia. Like the general population, the prevalence of dementia among patients in the study increased with age, with the rate rising from less than 1% of those aged 50-59 to 28% among the very old (90+). Consequently, patients with dementia tended to be older than those without the condition (median age of 83.7 versus 70.7), and were more likely to be female (60% versus 51%). To allow for these demographic differences, comparisons between patients with and without dementia use age-sex standardised estimates where applicable.
Greater use of hospitals
People with dementia had much higher hospitalisation rates than those without dementia: in New South Wales, 26% of people with dementia aged 50 and over had at least one overnight stay in a public hospital ending in 2006-07, compared with 12% of people without dementia. Also, patients with dementia:
- were more likely to have more than one multi-day stay in a year (62% versus 43%)
- had longer multi-day stays (mean of 18.3 days versus 9.1 days), and these stays were more likely to involve either a change in care type or a transfer between hospitals (18% versus 13%).
Different reasons for hospitalisation
Compared with people without dementia, people with dementia were more likely to be admitted because of:
- non-dementia mental and behavioural disorders or conditions of the nervous system (14% versus 5%)
- injury or poisoning (14% versus 11%), particularly head and limb injuries.
Their admission was less likely to be caused by neoplasms (4% versus 10%) or circulatory diseases (13% versus 19%).
Different destinations
People with dementia were less likely than others to return to living in the community on discharge (59% versus 88%), and more likely either to return to living in residential care, to enter residential care on discharge from hospital, or to die in hospital.