Hospital care for First Nations people with dementia
In 2021–22, there were 382 hospitalisations due to dementia (where dementia was the principal diagnosis or the main reason for the hospital admission) where the patient identified as a First Nations person.
First Nations men were more likely to be hospitalised due to dementia (23 hospitalisations per 10,000 First Nations men) than First Nations women (19 hospitalisations per 10,000 First Nations women) (Figure 12.9).
Refer to Hospital care for more information on overall hospitalisations for dementia in Australia and see the Technical notes for further information on hospitals data. For information about the quality of First Nations identification in hospitals data, see Indigenous identification in hospital separations data: quality report.
Figure 12.9: Hospitalisations for First Nations people due to dementia in 2021–22: age-standardised rate, by sex
A bar graph showing the age standardised rate of hospitalisations due to dementia for male and female First Nations people in 2021–22.
The average length of stay among First Nations people for hospitalisations due to dementia was 15.5 days, slightly higher than the average length of stay for all hospitalisations due to dementia in 2021–22 for non-Indigenous Australians (14.8 days).
There are many reasons why First Nations people may not want to use hospital services, such as: competing family and cultural obligations; distrust in the health system due to negative past and present experiences; a lack of culturally safe care options; communication barriers with medical staff, including barriers for First Nations people for whom English is a second language; limited access to health services in regional and remote locations requiring patients to receive care away from their community; high travel and other out-of-pocket costs, especially for people living in regional and remote locations (AHMAC 2017; Shaw 2016).
How did hospitalisations due to dementia for First Nations people vary by geographic area?
Given the small number of hospitalisations due to dementia for First Nations people in a given year, the rates of hospitalisations due to dementia presented in this analysis were aggregated over a 3-year period (2019–20, 2020–21 and 2021–22).
After adjusting for population differences, between 2019–20 and 2021–22, the age-standardised rate of hospitalisations due to dementia for First Nations people aged 40 years and over, was:
- highest in South Australia (42 hospitalisations per 10,000 First Nations people) followed by Western Australia (37 hospitalisations per 10,000) and was lowest in New South Wales (18 hospitalisations per 10,000)
- highest in Remote and Very Remote areas and Major Cities (25 hospitalisations per 10,000 First Nations people) and was lowest in Inner and Outer Regional areas (18 hospitalisations per 10,000) (Figure 12.10).
Figure 12.10: Hospitalisations for First Nations people due to dementia between 2019–20 and 2021–22: age-standardised rate, by state and territory and remoteness area
A bar graph showing the age standardised rate of hospitalisations due to dementia among First Nations people between 2019-20 and 2021–22 by remoteness area and state or territory.
What were the most common principal diagnoses for First Nations people when dementia was an additional diagnosis?
Previous sections have presented hospitalisations due to dementia (that is, when dementia was recorded as the principal diagnosis), but understanding hospitalisations with dementia (that is all hospitalisations with a record of dementia, whether as the principal and/or an additional diagnosis) provides important insights on the wide-ranging conditions that can lead people living with dementia to use hospital services. In 2021–22 there were nearly 1,160 hospitalisations of First Nations people with dementia.
The most common principal diagnoses among hospitalisations for First Nations people aged 40 years and over, where dementia was an additional diagnosis, were:
- Problems related to medical facilities and other health care (12.7%)
- Delirium, not induced by alcohol and other psychoactive substances (6.9%)
- Other disorders of urinary system (3.3%)
Other common principal diagnoses recorded for these hospitalisations included pneumonia, sepsis, femur fractures and a number of chronic conditions such as chronic obstructive pulmonary disease, cardiovascular diseases, and diabetes (Figure 12.11).
Figure 12.11: Common principal diagnoses for hospitalisations of First Nations people where dementia was an additional diagnosis in 2021–22: percent of hospitalisations, by sex
A bar chart showing the age standardised rates of hospitalisations by common principal diagnoses and sex for First Nations people where dementia was an additional diagnosis in 2021–22.
Supplementary codes for chronic health conditions, including dementia, were introduced to hospitalisations data in 2015 and have recently become available for analysis (see Box 9.1 for more information). These codes provide a new way to determine if a patient was hospitalised with dementia. When using principal diagnosis, additional diagnosis and supplementary codes, hospitalisations with dementia increase to about 3,100 hospitalisations of First Nations people aged over 40.
Australian Health Ministers’ Advisory Council (2017) Aboriginal and Torres Strait Islander Health Performance Framework 2017 report, Australian Health Ministers’ Advisory Council, Australian Government, accessed 17 August 2022.
Shaw C (2016) An evidence‑based approach to reducing discharge against medical advice amongst Aboriginal and Torres Strait Islander patients, The Deeble Institute for Health Policy Research, Australian Healthcare and Hospitals Association, accessed 17 August 2022.