Variation in Hospital Use at the End of Life Among New South Wales Residents Who Died in Hospital or Soon After Discharge.

J Aging Health 2019 May 26:898264319848582. Epub 2019 May 26.

2 Western Sydney Local Health District, North Parramatta, New South Wales, Australia.

Objective: Hospital use increases in the last 3 months of life. We aimed to examine its association with where people live and its variation across a large health jurisdiction.

Methods: We studied a number of emergency department presentations and days spent in hospital, and in-hospital deaths among decedents who were hospitalized within 30 days of death across 153 areas in New South Wales (NSW), Australia, during 2010-2015.

Results: Decedents' demographics and health status were associated with hospital use. Primary care and aged care supply had no or minimal influence, as opposed to the varying effects of areal factors-socioeconomic status, remoteness, and distance to hospital last admitted. Overall, there was an approximate 20% difference in hospital use by decedents across areas. In all, 18% to 57% of areas had hospital use that differed from the average.

Discussion: The observed disparity can inform targeted local efforts to strengthen the use of community care services and reduce the burden of end-of-life care on hospitals.

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http://dx.doi.org/10.1177/0898264319848582DOI Listing
May 2019
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