Table 4.
Characteristics and hospital-based service utilisation decedents aged ≥70, by sex and place of residence
| Females | Males | Major cities | Outside of major cities |
P-valuea (residence) |
|
|---|---|---|---|---|---|
| n (%)a | n (%)a | n (%) | n (%) | ||
| n = 18,316 | n = 16,092 | n = 23,449 | n = 10,810 | ||
| Cause of death | 0.002 | ||||
| Disease of the circulatory system | 7580 (41) | 5753 (36) | 8926 (38) | 4373 (40) | |
| Cancer | 3786 (21) | 4829 (30) | 5960 (25) | 2645 (24) | |
| Disease of the respiratory system | 1549 (8) | 1578 (10) | 2168 (9) | 952 (9) | |
| Dementia | 1176 (6) | 570 (4) | 1223 (5) | 523 (5) | |
| Other known cause | 3651 (20) | 2874 (18) | 4483 (19) | 2029 (19) | |
| Unknown cause | 574 (3) | 488 (3) | 689 (3) | 288 (3) | |
| Place of death | < 0.0001 | ||||
| Death recorded in inpatient settingb | 8889 (49) | 9548 (59) | 12,433 (53) | 5949 (55) | |
| Dead on arrival at ED | 316 (2) | 519 (3) | 549 (2) | 284 (3) | |
| Other/Not recorded | 9111 (50) | 6025 (37) | 10,467 (45) | 4577 (42) | |
| For cancer deaths: | n = 3786 | n = 4829 | n = 5960 | n = 2645 | < 0.0001 |
| Inpatient settingb | 2467 (65) | 3427 (71) | 4051 (68) | 1835 (70) | |
| Home | 503 (13) | 642 (13) | 756 (13) | 389 (15) | |
| Nursing home | 637 (17) | 603 (12) | 919 (15) | 321 (12) | |
| Unknown place of death | 179 (5) | 157 (3) | 234 (4) | 100 (4) | |
| n = 18,316 | n = 16,092 | n = 23,449 | n = 10,810 | ||
| Resident in RACF prior to deathc | 6080 (33) | 4382 (27) | 7475 (32) | 2971 (27) | < 0.0001 |
| Hospital usage | |||||
| At least one hospital episode (%) | 14,338 (78) | 14,028 (87) | 19,421 (83) | 8875 (82) | 0.10 |
| - Excluding terminal episode (%) | 11,419 (62) | 11,549 (72) | 15,895 (68) | 7032 (65) | < 0.0001 |
| Median no. of episodes (IQR) | 1 (1–3) | 2 (1–4) | 2 (1–3) | 2 (1–3) | 0.001d |
| Median days in hospital per person (IQR) | 14 (2–38) | 21 (5–45) | 17 (3–41) | 16 (3–42) | 0.31 |
| > 3 months in hospital (%) | 1167 (6) | 1129 (7) | 1386 (6) | 906 (8) | < 0.0001 |
| Had an episode > 30 days (%) | 3586 (20) | 3534 (22) | 4799 (20) | 2311 (21) | 0.05 |
| Spent time in ICU (%) | 1397 (8) | 1842 (11) | 2343 (10) | 887 (8) | < 0.0001 |
| Restricted Palliative care definitione (%) | 2086 (11) | 2402 (15) | 3631 (15) | 851 (8) | < 0.0001 |
| Broader Palliative care definitionf (%) | 3348 (18) | 3821 (24) | 5257 (22) | 1901 (18) | < 0.0001 |
| ED presentationsg | n = 11,618 | n = 9928 | n = 20,296 | n = 1245 | |
| At least one ED presentation (%) | 8849 (76) | 8268 (83) | 16,099 (79) | 1017 (82) | 0.04 |
| - Excluding terminal presentation (%) | 8564 (74) | 7887 (79) | 15,473 (76) | 977 (78) | 0.07 |
| Median no. of presentations (IQR) | 1 (1–3) | 2 (1–3) | 1 (1–3) | 2 (1–3) | 0.001 |
| > 3 ED presentations (%) | 1668 (14) | 1947 (20) | 3357 (17) | 258 (21) | 0.0001 |
Total N = 34,556
ED emergency department, RACF residential aged care facility, IQR interquartile range, ICU intensive care unit
aListed p-values represent unadjusted p-value for association with place of residence. All p-values for differences by sex were < 0.0001, except p = 0.02 for “> 3 months in hospital”
bIncludes death in hospital, hospice/palliative care ward of a hospital, or stand-alone hospice/palliative care unit
cIncludes patients who were admitted from or discharged to RACF in year preceding death
dAlthough they have the same median and IQR, the statistical test indicates the distribution of number of episodes was higher for “major cities” than “other”
eIncludes persons recorded as undergoing review by a specialist palliative care team or who were admitted to one of five stand-alone hospice/inpatient palliative care facilities in NSW
fPatients already captured in restricted definition, plus those referred to palliative care specialist teams or facilities, availing of a palliative care bed, and/or where service category/service-related group/diagnosis code indicated palliative care
gFor people resident in the geographical area where recording of ED presentations was complete
Note: Analyses by sex excluded 148 decedents with unknown sex, analyses by place of residence excluded 297 for whom place of residence was unknown