A Review of In-Hospital Mortality Among Patients Transferred From Residential Aged Care Facilities, 2015-2022.

Abstract

Objective: Australia has an ageing population, with an increasing number of older people needing to live in residential aged care facilities (RACFs). There are more Emergency department (ED) presentations by older people living in Australia, including those that are from RACF, and many die in hospital. The aim of this study was to perform a descriptive analysis of hospital deaths, comparing the characteristics of patients from Residential Aged Care Facilities (RACFs) to those from non-RACF accommodation.

Methods: This study examined data from the In-Hospital Death Database for a major metropolitan tertiary hospital. De-identified data from 2015 to 2022 were extracted and included in the analysis. Data for patients over the age of 16 were collected. Data were matched on age and sex between the two groups.

Results: Compared with non-RACF patients, patients from RACFs who died in hospital were more likely to have died from a respiratory illness, more likely to die in the ED, no more likely to have been a 28-day readmission, more likely to have been admitted under Geriatrics, less likely to have been a coroner's case, and had a shorter length of stay. A large proportion of deaths of RACF patients (15%) were in the ED. Approximately 40% of patients from RACFs who died in hospital had Advance Care Plans (ACPs) in place prior to hospitalisation.

Conclusions: The relatively large percentage of RACF patients that die in the ED is concerning and raises the question of whether their end-of-life care may have been more appropriately delivered within the RACF. The rate of ACP among RACF patients was low but comparable to other studies, and higher than among non-RACF patients.