A review of global research into common experiences in the last year of life in health and aged care settings, conducted by the Not For Profit Violet Initiative, reveals the huge cost on the health system.
The majority of the 180,000 deaths that occur annually, or 3,000 to 4,000 a week, occur in hospital, despite research showing that 70% of people wish to die at home. This adds about $4 billion to the cost burden on the health system, according to the Violet Initiative's 'Too Little, Too Late: Last Stage of Life Impact Report'.
With deaths in Australia expected to more than double to 402,800 by 2040, the costs and burden on the health system, already under pressure with large numbers of older patients ready to be discharged but awaiting a residential aged care place, will only intensify.
"Across the country, public health systems are constrained and often dysfunctional, overwhelmed by admissions of elderly, frail and terminally ill people who are in the last stages of life," the report notes.
"This results in hospital bed block, failure to conduct elective surgery, ED overcrowding, and ambulance ramping."
The report also notes that:
- The costs incurred by those who die in residential aged care are half those who die in hospital.
- 11% of Australia's Federal Health Budget is spent on the 1% of the population who die every year.
- 70-80% of hospital deaths occur in frail older patients admitted as emergencies.
- Per capita healthcare expenditure is up to four times higher for individuals in the last 6-12 months of life.
- At least 25% of all hospital beds are for patients in their last year of life.
- Nearly one-third of emergency calls in hospitals are for patients nearing the end of life.
- In the last 12 months of life, people average four hospital episodes and 33 days in hospital.
The Violet Initiative, which is chaired by Kate Carnell AO, Deputy Chair Beyond Blue and former ACT Chief Minister and ACT Health Minister, was founded to look into care in the last stage of life and improve the experience.