In-patient hospital use in the last years of life: a Western Australian population-based study.
OBJECTIVE
To estimate the likelihood and costs of in-patient care in the last three years of life.


METHODS
A population-based retrospective cohort study using linked hospital and death records to evaluate in-patient use by Western Australians who died in 2002.


RESULTS
Age was unrelated to the likelihood of in-patient admission and inversely related to in-patient costs, after adjustment for sex, cause of death and proximity to death. In-patient costs increased in the final three quarters before death. In the last quarter before death, the predicted average quarterly in-patient cost increased 2.8 fold from quarter two and 3.8 fold from quarter three.


CONCLUSIONS
Older decedents were not more likely to be hospitalised than younger decedents in the final three years of life. Moreover, once hospitalised, their in-patient costs were lower. In-patient costs were heavily concentrated in the three last quarters of life.


CONCLUSIONS
Remaining lifetime is a significant predictor of in-patient costs. Failure to account for proximity to death will overemphasise the impact of population ageing on health care expenditure, because older people have a higher probability of dying.
Calver
Janine
J
Centre for Research into Aged Care Services, Curtin University of Technology, Western Australia. janine.calver@health.wa.gov.au
Bulsara
Max
M
Boldy
Duncan
D