Optimising care for dementia patients after a fall
Taking advantage of improved data linkage systems within the Australian healthcare system is allowing researchers to map and better understand the patient journey.
The most common cause of hospitalisation in people with dementia is injury, predominantly as a result of a fall. Once in hospital, people with dementia have longer lengths of stay, experience a higher rate of complications such as urinary tract infections, pressure areas and delirium, and have poorer outcomes than cognitively healthy people of the same age. Hospitalisations for fall-related injuries in older people generally have increased over the last decade, however it is unknown what impact the increase in the prevalence of dementia in the community is having on this trend.
Dr Lara Harvey is an injury epidemiologist whose research utilises recent advances in data linkage capacity in Australia to develop a clear understanding of the causes, consequences and the human and economic cost of injury in people with dementia. The increased capacity means more information is available across a larger number of data sources.
Linking data from a number of large administrative health datasets provides, for the first time, the ability to track a person’s pathways through the health care system and also to map the subsequent health outcomes. Using data in this way creates a clearer picture of a person’s journey after a fall.
Although it is still early days, so far the news is good for people with dementia. Dr Harvey’s research highlights that rates of hospitalisation for people with dementia have decreased over the past ten years. Fall-related hip fracture rates have decreased by around 5% per year for people with dementia, yet there is no corresponding decrease for older people without dementia. The reasons for this unexpected finding are not clear and require further exploration.
Findings from Dr Harvey’s research will inform strategies, guide clinical practice and, ultimately, optimise the care provided to people with dementia who have sustained an injury through a fall.