Hospitalisations and emergency department presentations by older individuals accessing long-term aged care in Australia

Stephanie L. Harrison; Catherine Lang; Tesfahun C. Eshetie; Maria Crotty; Craig Whitehead; Keith Evans; Megan Corlis; Steve Wesselingh; Gillian E. Caughey; Maria C. Inacio

doi:10.1071/AH24019

RESEARCH ARTICLE (Open Access)

Hospitalisations and emergency department presentations by older individuals accessing long-term aged care in Australia

Stephanie L. Harrison ^A ^B ^* , Catherine Lang ^A , Tesfahun C. Eshetie ^A ^B ^C , Maria Crotty ^D ^E , Craig Whitehead ^D ^E , Keith Evans ^A , Megan Corlis ^F , Steve Wesselingh ^A ^G , Gillian E. Caughey ^A ^B and Maria C. Inacio ^A ^B

+ Author Affiliations

- Author Affiliations

^A Registry of Senior Australians, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.

^B Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.

^C UniSA Clinical & Health Sciences, University of South Australia, Adelaide, SA, Australia.

^D Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia.

^E College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

^F Australian Nursing and Midwifery Federation SA Branch, Adelaide, SA, Australia.

^G National Health and Medical Research Council, ACT, Australia.

^* Correspondence to: stephanie.harrison@sahmri.com

Australian Health Review 48(2) 182-190 https://doi.org/10.1071/AH24019

Submitted: 23 January 2024 Accepted: 6 March 2024 Published: 28 March 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

The study examined emergency department (ED) presentations, unplanned hospitalisations and potentially preventable hospitalisations in older people receiving long-term care by type of care received (i.e. permanent residential aged care or home care packages in the community), in Australia in 2019.

Methods

A retrospective cohort study was conducted using the Registry of Senior Australians National Historical Cohort. Individuals were included if they resided in South Australia, Queensland, Victoria or New South Wales, received a home care package or permanent residential aged care in 2019 and were aged ≥65 years. The cumulative incidence of ED presentations, unplanned hospitalisations and potentially preventable hospitalisations in each of the long-term care service types were estimated during the year. Days in hospital per 1000 individuals were also calculated.

Results

The study included 203,278 individuals accessing permanent residential aged care (209,639 episodes) and 118,999 accessing home care packages in the community (127,893 episodes). A higher proportion of people accessing home care packages had an ED presentation (43.1% [95% confidence interval, 42.8–43.3], vs 37.8% [37.6–38.0]), unplanned hospitalisation (39.8% [39.6–40.1] vs 33.4% [33.2–33.6]) and potentially preventable hospitalisation (11.8% [11.6–12.0] vs 8.2% [8.1–8.4]) than people accessing permanent residential aged care. Individuals with home care packages had more days in hospital due to unplanned hospitalisations than those in residential care (7745 vs 3049 days/1000 individuals).

Conclusions

While a high proportion of older people in long-term care have ED presentations, unplanned hospitalisations and potentially preventable hospitalisations, people in the community with home care packages experience these events at a higher frequency.

Keywords: aged care, emergency department presentations, home care, hospitalisations, long-term care, observational research, older adults, residential aged care.

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