In-patient hospital use in the last years of life: a Western Australian population-based study
Article first published online: 25 SEP 2007
Australian and New Zealand Journal of Public Health
Volume 30, Issue 2, pages 143–146, April 2006
How to Cite
Calver, J., Bulsara, M. and Boldy, D. (2006), In-patient hospital use in the last years of life: a Western Australian population-based study. Australian and New Zealand Journal of Public Health, 30: 143–146. doi: 10.1111/j.1467-842X.2006.tb00107.x
- Issue published online: 25 SEP 2007
- Article first published online: 25 SEP 2007
- Revision requested: June 2005 Accepted: September 2005
Objectives: To estimate the likelihood and costs of in-patient care in the last three years of life.
Methods: A population-based retrospective cohort study using linked hospital and death records to evaluate in-patient use by Western Australians who died in 2002.
Results: Age was unrelated to the likelihood of in-patient admission and inversely related to in-patient costs, after adjustment for sex, cause of death and proximity to death. In-patient costs increased in the final three quarters before death. In the last quarter before death, the predicted average quarterly in-patient cost increased 2.8 fold from quarter two and 3.8 fold from quarter three.
Conclusions: Older decedents were not more likely to be hospitalised than younger decedents in the final three years of life. Moreover, once hospitalised, their in-patient costs were lower. In-patient costs were heavily concentrated in the three last quarters of life.
Implications: Remaining lifetime is a significant predictor of in-patient costs. Failure to account for proximity to death will overemphasise the impact of population ageing on health care expenditure, because older people have a higher probability of dying.