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Most elderly return home after hospital

Most older Australians who are admitted to hospital are able to return to their home after they are discharged, despite one third of all admissions to residential aged care being from hospital, a new report shows

An Australian Institute of Health and Welfare report also found that the reasons for entering hospital are different for older people living at home than for those living in aged care, with those in aged care twice as likely to be admitted to hospital after a fall.

The report, Movement between hospital and residential aged care 2008-2009, focuses on people aged 65 years and older, and includes the first analysis of the use of hospitals by people already in residential care.

AIHW spokesperson Dr Pamela Kinnear said that about 90 per cent of the 1.1 million hospitalisations a year for older Australians were for people who lived at home in the community. Nearly all others were for those living in residential aged care.

“On leaving hospital, 83 per cent of patients returned to their home in the community and 8 per cent were discharged back to their home in residential care,” Dr Kinnear said.

“Just over 4 per cent of patients were admitted into residential care or transition care when they left hospital. The remaining 5 per cent of hospitalisations ended with the patient’s death.”

Dr Kinnear said factors such as age and having dementia increased the likelihood of a person entering care after being discharged.

“People were more likely to be admitted into residential aged care than return to the community if they were in hospital for longer, were diagnosed with dementia or stroke, were older, had an unplanned hospital admission, or were in palliative care before being discharged,” she said.

Aged care residents entered hospital for different reasons than older people living in the community.

“Respiratory conditions were the leading cause of admission for permanent aged care residents, while circulatory conditions were most common for people admitted from the community,” Dr Kinnear said.

Aged care residents were twice as likely as other older Australians to be admitted to hospital because of a fall (10 per cent versus 5 per cent).

There were just over 120,000 admissions into residential aged care nationally in 2008-09, including transfers between aged care facilities. Almost one-third of all these admissions were from hospital.

The report found that people who moved from living at home to living in permanent residential care via hospital had the longest stays in hospital, at an average of 28 days, compared with an overall average hospital stay of 6.1 days.

People who returned home on discharge tended to have the shortest stays. Death in hospital was generally preceded by a moderately short stay (a mean of 12 days).

Debra Vermeer

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