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


METHODS
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.


METHODS
Western Australia.


METHODS
All 68,875 persons aged 65 years and over who died between 1 January 1985 and 31 December 1994.


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.
Department of Public Health, University of Western Australia, Nedlands, Western Australia.
K J
KJ
Brameld
C D
CD
Holman
A J
AJ
Bass
J P
JP
Codde
I L
IL
Rouse
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D017721:Hospital Costs; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D006113:United Kingdom; D014904:Western Australia