2025/07/07 by Janine Alan, Bridget Laging, Peter Cameron +4 · 1 voice
Health Professions · Medicine · #Geriatric Care and Nursing Homes #Frailty in Older Adults #Palliative Care and End-of-Life Issues
paper · pdf · doi:10.1111/1742-6723.70092
openalex publication_date 2025/07/07 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
OBJECTIVE: To explore emergency hospitalisations from Victorian residential aged care facilities (RACFs). METHODS: Retrospective descriptive study of Victorian RACFs transfers to ED from 2015/16 to 2022/23. MAIN OUTCOME MEASURES: (1) ED event rate per 100 RACF beds; (2) Number of ED events, day/time, triage category, reason, comorbidity profile, length of stay, death within 12 months of ED presentation and costs; (3) Relationship between resident characteristics and total ED events; (4) Number of inpatient events, comorbidity profile, length of stay, intensive care use, preventable hospitalisations, diagnosis-related group, deaths and costs. RESULTS: The rate of ED presentations from Victorian RACFs from 2015/16 to 2022/23 ranged from 77 to 91 ED events per 100 RACF beds. Associated costs for ED and inpatient stay were over 2.8B. An advance care directive or substitute decision maker was unavailable for 84% of ED events. Eighty-seven per cent of residents presenting to ED were admitted; 90% for medical DRGs. Sixteen per cent of inpatient stays were potentially preventable under the national definition. CONCLUSION: Victorian RACF residents make substantial use of hospitals. This study highlights a significant gap in advance care planning (ACP), with causes potentially linked to inadequate planning, poor document quality or lack of accessibility. To enhance hospital-RACF interactions, it is essential to identify and address unmet palliative care needs at policy, planning, and practice levels, ensuring person-centred care for residents in their final years.