Dementia Patients Twice as Likely to Suffer Avoidable Complications in Hospital, New UC Study Finds

June 27, 2017

Hospital patients with dementia are more than twice as likely to experience preventable complications such as pressure ulcers and pneumonia, according to a new study by the University of Canberra.

The study, which was published in the BMC Health Services Research journal, found four complications in the treatment of patients aged over 50 cost $16,000 per person.

The team of six researchers found a diagnosis of pneumonia, urinary tract infections, pressure areas, and delirium resulted in an average of 3.6 additional days in hospital for those aged 50 or older.

"Our findings indicate that people with dementia have more than double the rates of complications than people without dementia and, consequently, a disproportionately large amount of the total additional costs," the report said.

"For both dementia and non-dementia patients, the complications were associated with an eightfold increase in length of stay and doubled the increased estimated mean episode cost."

Alzheimer's Australia chief executive Carol Bennett said the government's Intergenerational Report made it clear the country was facing an "avalanche of dementia cases in coming decades" and the hospital issue needed to be resolved quickly.

"We need to look at how hospitals can better meet the needs of dementia patients as it can be a very scary place for them," she said.

"People who are struggling cognitively tend to struggle in hospitals and that can exacerbate some of their symptoms, so it's not surprising they end up with complications."

Close to 340,000 Australians live with dementia with Alzheimer's disease accounting for between 50 and 70 per cent of cases.

In 2010, dementia was the third leading cause of death in Australia with prevalence of the condition likely to reach 900,000 by 2050.

The University of Canberra research assessed annual discharge records from NSW and found patients aged 65 and older amounted for almost half of hospital bed days.

"This study shows that they produce a burdensome financial cost and reveals that they are very important in understanding length of stay and costs in older and complex patients," the report said.

According to the report, patients with dementia cost on average $2710 more per hospital episode than those without dementia.

"They also have significantly higher rates of hospital-acquired complications which are known to be sensitive to nursing care … which we argue may be preventable," it said.

An Alzheimer's Australia report released last year found patients with dementia had a five-fold increase in mortality rates because they were more likely to experience falls, sepsis, or pressure ulcers while in hospital.

"Hospitals are not always the best place for people with dementia to receive care," the report said.

"In some situations, it is best for people with dementia to receive care within the home or within specialised residential aged care facilities."

Ms Bennett said the research and medical community were aware of the problems faced by dementia patients in hospital, but needed to act quickly.

"Certainly the first thing is to ensure that staff at hospitals have a good understanding of dementia and know how they can better assist patients," she said.

"We need to make sure people are managed in a way that they are not relied on to remember things such as taking their medication for example."

The University of Canberra report said a duty of care to patients and to taxpayers demands the risks of acquiring complications in hospital be mitigated.

"It is not clear how responsibility for prevention and mitigation is best shared between hospitals and the state, but research … has shown promise in prevention of these key hospital-acquired complications."

Ms Bennett said national awareness of dementia had increased in recent years due to more diagnosed conditions.

"If you haven't experienced dementia in your own family then you would probably know someone who has so it's something that is close to home for many," she said.

Reposted from Canberra Times

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