Broad Joanna B, Ashton Toni, Gott Merryn, McLeod Heather, Davis Peter B, Connolly Martin J
Freemasons' Department of Geriatric Medicine, Faculty of Medicine and Health Sciences, University of Auckland, New Zealand.
Health Systems, School of Population Health, University of Auckland, New Zealand.
Aust N Z J Public Health. 2015 Aug;39(4):374-9. doi: 10.1111/1753-6405.12374. Epub 2015 Jun 11.
In New Zealand (NZ), place of death among decedents aged 65+ years has been reported as residential aged care (RAC, 38%), acute hospital (34%) or elsewhere (28%). However, lifetime risk of use of RAC (or nursing homes) is unknown. A simple method of estimation is demonstrated for NZ and Australia, with comparisons to other countries.
Deaths of RAC residents in acute hospitals were estimated for NZ from four separate studies and added to deaths occurring in RAC, to derive the likelihood of using RAC after age 65 years. Academic and other sources were searched for comparative reports.
An estimated 18% of RAC residents died in acute hospital in NZ. When added to those who died in RAC, the proportion using RAC for late-life care was estimated at over 47% (66% if aged 85+ years). Of 12 US reports, the median report was 41%. Elsewhere, Finland was 47%, UK 28%, Australia 34% to 53%, and Germany 22% & 26%.
Simple estimation using existing data demonstrates that RAC in late life is common.
Late-life care services will continue to evolve. Monitoring RAC utilisation is necessary for informed debate about palliative care provision in RAC, use of hospital by RAC residents and for planning and policy setting.
在新西兰（NZ），据报告65岁及以上死者的死亡地点为老年护理机构（RAC，38%）、急症医院（34%）或其他地方（28%）。然而，使用老年护理机构（或疗养院）的终生风险尚不清楚。本文展示了一种针对新西兰和澳大利亚的简单估计方法，并与其他国家进行了比较。
从四项独立研究中估算出新西兰急症医院中RAC居民的死亡人数，并将其与RAC中发生的死亡人数相加，以得出65岁以后使用RAC的可能性。检索学术及其他来源以获取比较报告。
在新西兰，估计有18%的RAC居民死于急症医院。将其与在RAC中死亡的人数相加后，估计晚年接受RAC护理的比例超过47%（85岁及以上者为66%）。在美国的12份报告中，中位数报告为41%。在其他地方，芬兰为47%，英国为28%，澳大利亚为34%至53%，德国为22%和26%。
使用现有数据进行的简单估计表明，晚年接受RAC护理很常见。
晚年护理服务将继续发展。监测RAC的利用率对于就RAC中的姑息治疗提供、RAC居民对医院的使用以及规划和政策制定进行明智的辩论是必要的。
