Funding Body

Research Operational Funding

Project Description

Hospital admissions represent a significant cost to the Western Australian community.  This study has been developed to facilitate a better understanding of the characteristics of community care clients who have frequent and/or excessively lengthy hospitalisations and to determine whether it is possible to identify these persons in advance.

This study builds on three earlier studies conducted in Silver Chain.  The first, the 1998 Hospital Admissions Study, had two findings of particular significance to this study.  Firstly that clients who were receiving care for an acute episode on top of an ongoing need for maintenance home care services were more than twice as likely to be admitted to hospital than those who were receiving maintenance support only.  Secondly that falls, cardiovascular and respiratory disease accounted for the largest numbers of admissions. 

The second study completed by Silver Chain in 2003 formed part of the Continuing Care Linkage Study which examined inter-sectoral communication in client care with particular reference to hospital admissions among Silver Chain clients.  This project which linked hospital morbidity data to Silver Chain client data, identified that there were gaps in communication between hospitals and Silver Chain and whilst it depended on the service being received, Silver Chain was overall only aware of 40% of its clients’ admissions to hospital. 

The third study conducted in 2005, using only Silver Chain data, looked specifically at hospitalisations of clients with chronic disease between 1 April 2004 and March 31 2005.  This study found that nearly one quarter of the 3768 clients with a recorded diagnosis of congestive heart failure, diabetes or chronic obstructive pulmonary disease had a period of hospitalisation recorded on their client record during this period.
 
The specific objectives of the current study are to:

• Identify those Silver Chain clients who were admitted to hospital during the 5 year period 1 January 2000 through to 31 December 2004, and describe their admissions.
• Describe the demographic and clinical characteristics of the Silver Chain clients who experienced these hospital admissions.
• Determine whether it is possible to identify, prior to admission, community care clients who subsequently have frequent and/or lengthy hospital stays.

The data required for this project include a subset of the hospital morbidity database containing admission and diagnostic information, date of death data from the mortality register and selected demographic, assessment and service delivery data from Silver Chain’s ComCare.  These data will be analysed to provide a detailed description of Silver Chain clients’ hospital admissions with subgroup analyses of the admissions of Silver Chain clients with high hospital use.  The association between hospitalisation and client characteristics will be investigated using a backward binary logistic model.

Project Update

Analysis of data is almost complete.

For further information please contact
Joanna Smith
Senior Research Officer
JMSmith@silverchain.org.au