title: Likelihood of residential aged care use in later life: a simple approach to estimation with international comparison.
abstract: OBJECTIVE
  In New Zealand (NZ), place of death among decedents aged 65+ years has been reported as residential aged care (RAC, 38%), acute hospital (34%) or elsewhere (28%). However, lifetime risk of use of RAC (or nursing homes) is unknown. A simple method of estimation is demonstrated for NZ and Australia, with comparisons to other countries.
  
  
  METHODS
  Deaths of RAC residents in acute hospitals were estimated for NZ from four separate studies and added to deaths occurring in RAC, to derive the likelihood of using RAC after age 65 years. Academic and other sources were searched for comparative reports.
  
  
  RESULTS
  An estimated 18% of RAC residents died in acute hospital in NZ. When added to those who died in RAC, the proportion using RAC for late-life care was estimated at over 47% (66% if aged 85+ years). Of 12 US reports, the median report was 41%. Elsewhere, Finland was 47%, UK 28%, Australia 34% to 53%, and Germany 22% & 26%.
  
  
  CONCLUSIONS
  Simple estimation using existing data demonstrates that RAC in late life is common.
  
  
  CONCLUSIONS
  Late-life care services will continue to evolve. Monitoring RAC utilisation is necessary for informed debate about palliative care provision in RAC, use of hospital by RAC residents and for planning and policy setting.
authors.affiliation: Freemasons' Department of Geriatric Medicine, Faculty of Medicine and Health Sciences, University of Auckland, New Zealand.
authors.forename: Joanna B
authors.initials: JB
authors.lastname: Broad
authors.affiliation: Health Systems, School of Population Health, University of Auckland, New Zealand.
authors.forename: Toni
authors.initials: T
authors.lastname: Ashton
authors.affiliation: School of Nursing, University of Auckland, New Zealand.
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
authors.affiliation: Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), University of Otago, New Zealand.
authors.forename: Heather
authors.initials: H
authors.lastname: McLeod
authors.affiliation: COMPASS Research Centre, University of Auckland, New Zealand.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Davis
authors.affiliation: Waitemata District Health Board, New Zealand.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Connolly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009520:New Zealand; D009735:Nursing Homes / Q000706:statistics & numerical data*
keywords: frail elderly; lifetime use; long-term care of older people; palliative care