The proportion of the population aged over 65 is projected to increase from 13% in 2004 to 20% by 2024. As hospital use increases with age (after the age of 50), this ageing of the Australian population can be expected to affect both the demand for and provision of hospital services. In addition, there is evidence that a period in hospital can have an adverse effect on the health of frail older people or people with dementia. Because of their high use of hospital services, and the consequent impact on personal wellbeing and service provision, it is important to understand why older people enter hospital and the characteristics of their stays. This bulletin examines these questions using data for 2004–05. In summary:
- Older people are bigger users of hospitals than their younger counterparts, with 53% (29,000) of people in hospital on the night of 30 June 2004 being aged 65 years and over. Throughout 2004–05, 37% of episodes lasting at least one night (or 'overnight' episodes) were for older people.
- At all ages, older men have higher rates of hospital use than older women, and during 2004–05 there were 474.5 overnight hospital episodes per 1,000 older men compared with 414.0 for older women. However, as older women make up a larger proportion of the older population, more overnight hospital episodes (52% in 2004–05) are for women than for men.
- People may receive different types of care while in hospital. The proportion of episodes that are for rehabilitation, geriatric evaluation and management, and maintenance care all increase with age. Consequently, the relative use of acute care decreases with increasing age, going from 94% of hospital episodes for people aged 65–69 down to 85% among very old patients in 2004–05.
- On average, older people have longer hospital episodes than younger people, the result of a combination of longer stays in acute care and a higher proportion using non-acute care.
- For acute-care episodes, the length of stay increases steadily with age; however, there is no such relationship for other care types.
- In 2004–05, one-fifth of hospitalisations for both older men and women were due to diseases of the circulatory system. Cancers and tumours were the next most common cause (11%). However, the prominence of particular diseases changes with age and sex.
- In many cases, injuries and poisonings resulting in hospitalisation are avoidable. For older people, falls are the most common cause of such injuries. Hospitalisation due to a fall increases with age—from 7.2 overnight hospitalisations per 1,000 people aged 65–74 to 63.5 per 1,000 people aged 85 and over in 2004–05. Older patients in hospital due to injury have relatively long stays.
- On discharge, older patients are less likely to return to their usual residence, and more likely than younger patients to go into residential care or to have died. A relatively high proportion of injury-related hospital episodes result in discharge to residential aged care or to another health facility.