Aims
Analyse ACT public hospital ED presentations and admitted patient care (APC) data for people with documented dementia, to inform the development of an evidence-based framework for people living with dementia.
Methods
Retrospective analysis of ACT Health’s APC data between financial year 2018-19 to 2022-23 of people who presented to ED or admitted with documented dementia diagnosis (primary and secondary dementia diagnosis based on ICD-10-AM). Medical record review using the ACT Digital Health Record (from November 2022) or Clinical Patient Folder. Common reasons for presentation or admission, hospital acquired complications (HAC) rates and factors affecting length of stay were studied.
Results
A total of 2636 patients with diagnosis of dementia, 5738 inpatient episodes of care (EOC) and 6155 ED presentations were identified. The most common reason for ED presentation was delirium. Hospital acquired complication (HAC) rate per 10,000 EOC was higher in patients with dementia diagnosis compared to overall inpatient population. HAC rate for patients with dementia increased from 700/10,000 EOCs (2019) to nearly 900/10,000 EOC (2023), with five HACs accounting for 80% of the total. During FY2018-23, EOC for people with a primary or secondary diagnosis of dementia increased by 11 per cent (1167 to 1294) and the estimated funding impact increased by 27 per cent ($18.3 million to $23.3 million).
Conclusions
Understanding ED and APC data for people living with dementia in the ACT has informed a framework for health service planning with HACS and increased length of stay key drivers to increased costs.