Third of aged-care residents admitted to emergency each year

More than one in three nursing home residents over 65 required treatment in a hospital emergency department in 2018-19.

More than one in three nursing home residents over 65 required treatment in a hospital emergency department in 2018-19, with many of the admissions relating to events such as falls or malnutrition.

Research prepared for the aged-care royal commission finds increasing rates of emergency hospitalisations among people living in residential aged care, up from 32.7 per cent in 2014-15 to 36.9 per cent in 2018-19.

It is the first time aged-care hospitalisation rates have been calculated at a national level, using state and territory hospital and emergency department data obtained under the royal commission’s investigatory powers.

While increasing frailty among an ageing cohort is part of the reason, a significant proportion are potentially preventable incidents, the paper, Hospitalisations in Australian Aged Care 2014-15 to 2018-19, concludes.

 

In 2018-19, 10.5 per cent of residents were hospitalised for a fall, 5.4 per cent for a fracture, 3.4 per cent for a pressure injury and 1.9 per cent for weight loss or malnutrition, the report finds.

Hospitalisations, particularly for preventable incidents, is an important marker of the quality of aged care services, but publicly available information in Australia has been limited to date.

The new data shows variations among individual aged-care facilities, and can potentially offer those considering a new care home information about its level of quality and safety, and assist providers to improve services.

Beyond the emergency presentation data, the report also shows that in 2018-19, 31 per cent of nursing home residents over 65 were admitted to a public hospital at least once (increasing to about 37 per cent when private hospital admissions are included).

The most common reasons for hospital admissions and emergency presentations were respiratory disease, injuries, circulatory disease and dialysis.

While total hospitalisation rates for over-65s in nursing homes were lower than for over-65s in the general community, the rate of emergency department presentations was significantly higher.

In 2018-19 there were 938 emergency department presentations per 1000 people in permanent residential aged care, compared to 671 per 1000 in the general community.

The paper points to quality of care within a nursing home as a potentially contributing factor, as well as the types of health services they receive while in aged care.

It notes that falls had increased over the previous five years, from 8.5 per cent of residents being hospitalised for a fall in 2014-15 to 10.5 per cent in 2018-19.

Other potentially preventable hospitalisations were also reported in the commission’s paper.

For instance, 3.4 per cent of residents had one or more hospitalisations in 2018-19 with a pressure injury, such as bed sores.