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Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Nov 1998; 52(11): 740–744.
PMCID: PMC1756640

Hospitalisation of the elderly during the last year of life: an application of record linkage in Western Australia 1985-1994

Abstract

STUDY OBJECTIVE: To measure the trend, pattern, and cost of time spent in hospital during the last year of life in Western Australia and to identify trends in the place of death. The results were compared with those reported from the Oxford Record Linkage Study. DESIGN: Mortality records for those aged 65 years and over were linked to inpatient hospital morbidity records with a date of separation within one year before death. Comparative inpatient resource utilisation was estimated using ANDRG 3.0 cost weights for Australian public hospitals. SETTING: Western Australia. PARTICIPANTS: All 68,875 persons aged 65 years and over who died between 1 January 1985 and 31 December 1994. MAIN RESULTS: Increasing proportions of all age groups (65-74, 75-84, and 85+ years) were admitted to hospital at least once in the year before death during 1985-94, but the chance of admission decreased with age. There was a trend towards a greater number of shorter admissions per person. Total bed days per person showed no significant increase, except at ages 65-74 years. Total inpatient resource utilisation during the last year of life was lowest and remained constant in those aged 85 years and over, while increasing gradually (3.7% per annum) in the younger elderly. The Western Australian population spent more time in hospital in the last year of life at ages 65-74 years, but the advanced elderly spent less time in hospital, when compared with the Oxford Region. CONCLUSIONS: Recent gains in life expectancy and higher per capita health expenditure have not been accompanied by more time spent in hospital during the last year of life at ages 75+ years. International differences between Western Australia and Oxford can be explained by differences in aged care provision.

 

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Selected References

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  • Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980 Jul 17;303(3):130–135. [PubMed]
  • Henderson J, Goldacre MJ, Griffith M. Hospital care for the elderly in the final year of life: a population based study. BMJ. 1990 Jul 7;301(6742):17–19. [PMC free article] [PubMed]
  • Goldacre MJ, Simmons H, Henderson J, Gill LE. Trends in episode based and person based rates of admission to hospital in the Oxford record linkage study area. Br Med J (Clin Res Ed) 1988 Feb 20;296(6621):583–585. [PMC free article] [PubMed]
  • Ferguson JA, Goldacre MJ, Henderson J, Bron AJ. Ophthalmology in the Oxford region: analysis of time trends from linked statistics. Eye (Lond) 1991;5(Pt 3):379–384. [PubMed]
  • Harrison ML, Graff LA, Roos NP, Brownell MD. Discharging patients earlier from Winnipeg hospitals: does it adversely affect quality of care? CMAJ. 1995 Sep 15;153(6):745–751. [PMC free article] [PubMed]
  • Kahn KL, Keeler EB, Sherwood MJ, Rogers WH, Draper D, Bentow SS, Reinisch EJ, Rubenstein LV, Kosecoff J, Brook RH. Comparing outcomes of care before and after implementation of the DRG-based prospective payment system. JAMA. 1990 Oct 17;264(15):1984–1988. [PubMed]
  • Goldacre MJ, Ferguson JA. In-patient workload in medical specialties: 1. Demographic profiles and time trends from linked statistics. QJM. 1995 Sep;88(9):649–659. [PubMed]
  • Weinberg J. The impact of ageing upon the need for medical beds: a Monte-Carlo simulation. J Public Health Med. 1995 Sep;17(3):290–296. [PubMed]
  • Townsend J, Frank AO, Fermont D, Dyer S, Karran O, Walgrove A, Piper M. Terminal cancer care and patients' preference for place of death: a prospective study. BMJ. 1990 Sep 1;301(6749):415–417. [PMC free article] [PubMed]
  • McWhinney IR, Bass MJ, Orr V. Factors associated with location of death (home or hospital) of patients referred to a palliative care team. CMAJ. 1995 Feb 1;152(3):361–367. [PMC free article] [PubMed]
  • Temkin-Greener H, Meiners MR, Petty EA, Szydlowski JS. The use and cost of health services prior to death: a comparison of the Medicare-only and the Medicare-Medicaid elderly populations. Milbank Q. 1992;70(4):679–701. [PubMed]
  • Scitovsky AA. Medical care in the last twelve months of life: the relation between age, functional status, and medical care expenditures. Milbank Q. 1988;66(4):640–660. [PubMed]
  • Roos NP, Montgomery P, Roos LL. Health care utilization in the years prior to death. Milbank Q. 1987;65(2):231–254. [PubMed]

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