Figures show decrease in rate of dementia hospitalisations

New statistics have been released showing falling hospitalisation rates for people with dementia and conservative prescribing of anti-dementia medication.

There were almost 95,000 cases of people with dementia being admitted to hospital in 2016-17, representing a 23 per cent decrease in hospitalisation rates from 10 years ago, according to newly released government statistics.

An Australian Institute of Health and Welfare report, Hospital care for people with dementia 2016-17, says there were 94,800 admissions for people with dementia over 12 months.

However the rate of dementia hospitalisations decreased by almost a quarter – from 408 hospitalisations per 100,000 population in 2007 to 313 in 2017.

AIHW spokesman Richard Juckes says the reasons for this are unclear but may be related to dementia classification.

“The reductions are all in what we call unspecified dementia, whereas there have been increases in other parts of dementia, such as Alzheimer’s disease, so I think part of it is better classification of dementia,” he told Community Care Review.

“But that can’t explain all of it, so whether there’s an increasing role of aged care or some other factor is something we need to investigate.”

One in five people with dementia admitted to hospital ended up in residential care for the first time and six per cent died in hospital.

The average length of stay was 13 days while 92 per cent of hospitalisations involved at least one overnight stay.

Up to 436,000 Australians were affected by dementia in 2018 and the condition was responsible for more than 13,700 deaths in 2017, the AIHW says.

Dementia hospitalisations linked to other problems

Dementia was the main diagnosis for about one in five of the hospitalisations, the AIHW found, but it existed among other health problems in the vast majority of other diagnoses.

Juanita Breen

The report shows that most patients hospitalised with dementia had an average of eight additional health problems, mainly related to urinary system issues and diabetes.

“Where dementia was an additional diagnosis, the most common principal diagnosis was related to injury, and more than 1 in 3 of these were for a leg fracture,” AIHW spokesman Richard Juckes said.

In one of three hopsitalisations the report looked at the patient was diagnosed with unspecified dementia. Twenty-seven per cent were for Alzheimer’s disease.

In the half the cases the patients were discharged, 17 per cent were transferred to residential care for the first time and the patient died in hospital in six per cent of cases.

“The AIHW results highlight that although there is a decline in hospital admissions for people with dementia, an significant number are still being admitted to hospitals, with many admissions linked to urinary problems and what appears to be falls that result in fractures, Dr Juanita Breen, a Senior Lecturer at the Wicking Dementia Research and Education Centre at the University of Tasmania, told Community Care Review.

She said the data highlighted the need to optimise hospital care for people with dementia, including training health practitioners in communicating with people with dementia, providing dementia companions and ensuring pathways for care after diagnosis.

Use of dementia medication

Meanwhile a separate AIHW report, Dispensing Patterns for anti-dementia medications 2016-17, found the government spent $20 million on medications used to reduce the severity and progression of  dementia symptoms, and improve quality of life.

It found four medications, Donepezil, Galantamine, Rivastigmine and Memantine were dispensed 546,000 times in 2016-17 to 58,000 people, with Donepezil accounting for 65 per cent of those.

General practitioners prescribed about 80 per cent of medications.

Dr Kim Lind, a research fellow at the Centre for Health Systems and Safety Research at Macquarie University, says those figures reflect a conservative use of anti-dementia medication in Australia, which may be related to restrictive subsidy guidelines.

“When you look at the number people the medications are actually dispensed for … we’re looking at about 13 per cent of people with dementia, so it’s pretty low compared to for example the US where it’s closer to 40 per cent,” she said.

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Tags: aihw, dementia, dispensing-patterns, hospitalisations, juanita-breen, kim-lind, news-ccr-1, wicking-dementia-centre,

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