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Table 4 Characteristics and hospital-based service utilisation decedents aged ≥70, by sex and place of residence

From: Health-services utilisation amongst older persons during the last year of life: a population-based study

 

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

  1. Total N = 34,556
  2. ED emergency department, RACF residential aged care facility, IQR interquartile range, ICU intensive care unit
  3. 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”
  4. bIncludes death in hospital, hospice/palliative care ward of a hospital, or stand-alone hospice/palliative care unit
  5. cIncludes patients who were admitted from or discharged to RACF in year preceding death
  6. 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”
  7. 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
  8. 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
  9. gFor people resident in the geographical area where recording of ED presentations was complete
  10. Note: Analyses by sex excluded 148 decedents with unknown sex, analyses by place of residence excluded 297 for whom place of residence was unknown