Hospital admissions of community-dwellers and residents in longterm care (LTC): Debunking a myth

Abstract

Introduction: Hospitalisation rates from nursing homes in UK, Australia and Scandinavia are up to double those of communitydwellers. Hospitalisations from LTC residents are not described for New Zealand. Our aim was to compare hospitalisation rates of LTC residents with those of community-dwelling older people. Methods: National databases provided information for publiclyfunded hospitalisations in Auckland. Age- and gender-specific annual hospitalisation rates for LTC residents were estimated based on residents included in the OPAL survey [1,2], and by subtraction for community-dwelling residents. The Australia Refined Diagnosis Related Groups v5.0 definitions categorized admissions into selected disease groupings. Results: 73,514 hospitalisations occurred from the population of 129,870 aged 65+ years. Annual age-standardised admission rates for the population aged 65+ were 54.9 [95%CI: 52.1,57.8] per 100 personyears for LTC residents and 60.2 [95%CI: 59.8,60.7] per 100 personyears for community dwellers. Hospitalisation rates rose markedly with age among community-dwellers, but not for LTC residents. Men were admitted more thanwomen across all age groups of communitydwellers, but not for LTC residents. LTC residentswere hospitalised less than community-dwellers overall (particularly for surgical or other planned procedures, for ear, nose and throat, and circulatory disorders). For disorders of the urinary tract, respiratory and nervous systems they were hospitalised more often. Key conclusions: Hospitalisation rates from LTC were lower than community-dwellers, contrasting with overseas reports. Findings from one country may not apply in other health systems; results of intervention studies are therefore not necessarily generalisable. References [1] Broad JB et al. Age Ageing 2011;40(4):487–94. [2] Boyd M et al. J Am Med Dir Assoc 2011;12(7):535–40.