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Understanding how people with dementia use health services in their last year of life

Photo: Understanding how people with dementia use health services in their last year of....
In one of the first studies of its kind in Australia, the use of health services by people with dementia in their last year of life has been examined in a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Patterns of health service use by people with dementia in their last year of life, brings together de-identified data on public hospital admissions, GP and specialist visits, emergency department care, and dispensing of prescription medications. The linked database used in this study did not contain aged care data.

‘By bringing together different sources of data to tell a more complete story, the study demonstrates the potential for integrated health data to address gaps in our current understanding of a range of health issues, in this case dementia,’ said AIHW spokesperson Dr. Fleur de Crespigny.
The study examined health service use in New South Wales and Victoria by more than 70,000 people in the 12 months prior to their death in 2013, and sought to describe the patterns of health service use by people with and without dementia.

Of these, 19,222 (27%) were identified as having dementia and 50,928 (73%) had no record of dementia.

‘All Australians deserve appropriate care in their final years of life, and examining how health services are used by people with and without dementia in their last year of life is important for policy development and health service planning,’ Dr. de Crespigny said.

The report showed that people with dementia who died aged 65 and over used health services less than people without dementia in their last year of life, with the exception of GP services.

The use of health services decreased with increasing age at death, regardless of whether they had dementia or not.

‘There was also a notable difference in health services used by people who died with younger-onset dementia compared to those with dementia who died aged 65 or over—almost half of people with younger-onset dementia were admitted to hospital or presented to the emergency department in their final month of life, compared with just over one-third of people with dementia who died aged 65 and over,’ Dr. de Crespigny said.

‘It is important to note that how a person with dementia uses health services in their final year of life is likely to be influenced by a number of factors, including the impact of these services on their quality of life, personal views, family views and medical opinions.’

Dementia is a collection of symptoms—usually progressive in nature—caused by a range of disorders affecting the brain. The prevalence of dementia increases with age, mainly occurring among those aged 65 and over, and often co-exists with other age-related conditions.

The number of Australians with dementia is projected to more than double between 2020 and 2050—without a significant breakthrough in prevention or treatment, dementia will have an increasingly major impact on Australia’s health and aged care systems.

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