Movement from hospital to 
residential aged care

The Australian Institute of Health and Welfare is Australia’s national health and welfare statistics and information agency. The Institute’s mission is better information and statistics for better health and wellbeing.

Please note that as with all statistical reports there is the potential for minor revisions of data in this report over its life. Please refer to the online version at <www.aihw.gov.au>.

Movement from hospital to 
residential aged care

Rosemary Karmel
Jonas Lloyd
Phil Anderson
2008

© Australian Institute of Health and Welfare 2008

This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Media and Communications Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601.

This publication is part of the Australian Institute of Health and Welfare’s Data linkage series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. 

ISSN 1833-1238
ISBN 978 1 74024 858 7

Suggested citation 
AIHW: Karmel R, Lloyd J, Anderson P 2008. Movement from hospital to residential aged care. Data linkage series no. 6. Cat. no. CSI 6. Canberra: AIHW.

Australian Institute of Health and Welfare 
Board Chair
Hon. Peter Collins, AM, QC

Director 
Penny Allbon

Any enquiries about or comments on this publication should be directed to:
Community Services Integration and Justice Health Unit
Australian Institute of Health and Welfare
GPO Box 570
Canberra ACT 2601
Phone: (02) 6244 1000
Email: rosemary.karmel@aihw.gov.au

Published by the Australian Institute of Health and Welfare
Printed by Union Offset Printers 

Contents
Preface
Acknowledgments
Abbreviations
Symbols used in tables
Summary
1	Introduction
1.1	Event data
1.2	Linkage method
1.3	Approximate estimates of flow
2	Regional movements
3	Leaving hospital
3.1	Characteristics of patients leaving hospital
3.2	Length of stay
3.3	Hospital care type
3.4	Hospital diagnosis
3.5	Regional profile
4	Moving into residential aged care
4.1	Characteristics of people admitted into residential aged care
4.2	Place of assessment
4.3	Care needs
4.4	Regional profile
5	Analysis of person outcomes
5.1	Factors affecting entry into RAC from hospital
5.2	Short-term use of residential aged care following a period in hospital
5.3	Survival of people admitted into permanent residential aged care
6	People with selected health conditions
6.1	Prevalence of selected conditions
6.2	Characteristics of people leaving hospital
6.3	Hospital care characteristics
6.4	Length of stay in hospital
6.5	Short-term use of residential aged care
7	Refining the methods
Appendix A: Additional tables

Appendix B: Data linkage
B.1	Transition events
B.2	Data
B.3	Linkage protocol
B.4	Linkage process: constrained event-based matching
B.5	Link accuracy
B.6	Estimates of total flow
Appendix C: ICD-10-AM Edition 2 chapters
Appendix D: English proficiency groups
Appendix E: Logistic regression models for factors affecting admission into RAC 
from hospital
E.1	The model
E.2	Predicted probabilities
E.3	Odds ratios
Appendix F: Survival analysis of people entering permanent RAC
Appendix G: Suppression of small cells
G.1	Derived statistics within table cells
G.2	Small cells within totals or subtotals > 1,000
G.3	Small cells within totals or subtotals ≤ 1,000
References
List of tables
List of figures
List of boxes

Preface
Every year in Australia almost 10% of the 1 million or so hospital discharges for older people are for people who then go into or return to residential aged care. Prior to this report, not only was the extent of this flow unknown but also little was known about why these people enter hospital, what health conditions they have, nor what happens to them after they move. It was not possible to follow individuals from their hospital discharge into residential care because the national hospital data were not linked to the residential care data.
During 2001 and 2002, the Australian Health Ministers’ Advisory Council (AHMAC) Care of Older Australians Working Group supported the Australian Institute of Health and Welfare (AIHW) in trialling the linking of data in the National Hospital Morbidity Database with data collected by the Australian Department of Health and Ageing from residential aged care facilities. The AIHW method did not use the names of individuals or person identifiers to make the linkage as these are not available on both national data sets.
Between 2003 and 2005, the method was further tested and developed. In 2004–05, the Statistical Information Management Committee (SIMC) of the National Health Information Group assisted in funding a comparison between the AIHW method with a name-based linkage method using Western Australian data. The comparison, jointly undertaken by AIHW and the Health Information Linkage Branch in the Western Australian Department of Health, tested the accuracy and utility of the AIHW method. The comparison showed that the AIHW’s method could be used to accurately link hospital and residential aged care data. The results of the comparison were published in Comparing name-based and event-based strategies for data linkage: a study linking hospital and residential aged care data for Western Australia (AIHW: Karmel & Rosman 2007).
In 2006–07, SIMC and AIHW jointly funded an investigation to see whether the AIHW method could address key policy issues associated with the movement from hospital care to residential aged care. This report is the outcome. It shows how the linked data can describe the characteristics of people moving from hospital to residential aged care and examine the factors that influence outcomes for people moving from hospital to residential care. 
The AIHW receives national hospital separation data from the states and territories and the residential aged care data from the Commonwealth for national reporting purposes. The AIHW has a critical role in ensuring compatibility between data collections and consults widely with the states and territories to ensure compatible collection methods and standards that are acceptable to all jurisdictions. As a national institution, the AIHW is committed to better use of existing data to inform national policy and improve service delivery. Linking national data under a strong privacy and ethics regime is critical to that role. 
I congratulate the authors on their innovative work in this important area.

Penny Allbon
November 2008 
Acknowledgments
This resport was authored by Rosemary Karmel, Jonas Lloyd and Phil Anderson of the Community Services Integration and Justice Health Unit at the Australian Institute of Health and Welfare.
The authors thank the members of project steering committee which provided guidance during the development of the reporting template and resulting publication. This committee consisted of representatives of the Department of Health and Ageing (as the owner of the residential aged care data set), of the states and territories (as owners of the hospital morbidity data), and of the Director of the AIHW, and a nominee from the AHMAC Care of Older Australians Working Group. 
The authors also thank the Department of Health and Ageing for permission to use their residential aged care data for this project, and Peter Braun (AIHW), who prepared the residential aged care data for use in the project. Thanks also go to the jurisdictional data custodians for permission to use their hospital data, and to Katrina Burgess and Christina Barry (AIHW), who prepared the hospital data for use in this project. Rachel Aalders (AIHW) provided valuable comment on the draft.
This project was partly funded from the AHMAC cost-shared budget.
Abbreviations 
ACAT	Aged Care Assessment Team
ACCMIS	Aged and Community Care Management Information System
ACT	Australian Capital Territory
AHMAC	Australian Health Ministers’ Advisory Council
AIHW	Australian Institute of Health and Welfare
COPD	chronic pulmonary obstructive disease
DOB	date of birth
EP	English proficiency 
ICD-10-AM	International Classification of Diseases 10th revision Australian Modification, based on the World Health Organization’s internationally accepted classification of diseases and related health conditions. NHMD data for 2001–02 uses edition 2 of the classification. 
NDI	National Death Index
NHMD	National Hospital Morbidity Database
NSW	New South Wales
NT	Northern Territory
p	probability of result occurring by chance ( p = 0.05 equates to a 5% probability)
PPV	positive predictive value
Qld	Queensland
RAC	residential aged care
RCS	Resident Classification Scale
SA	South Australia
Tas	Tasmania
Vic	Victoria
WA	Western Australia
YOB	year of birth
Symbols used in tables
—	nil or rounded to zero
. . 	not applicable 
N	number
n.p.	not published
Summary
Background
The movement of people between acute hospital care and residential aged care (RAC) has long been recognised as an important issue, but existing national data sets provide only limited information on such movement. Over recent years the Australian Institute of Health and Welfare has developed and tested an event-based data linkage method to link national hospital morbidity data and residential aged care data, with the aim of improving national reporting on the acute care/aged care interface.
National data were linked for 2001–02 using this linkage method. The linked database provides a useful resource for investigating key policy issues, including:
•	What is the extent of movement between the two sectors?
•	Are older people staying too long in hospital before admission into residential aged care? 
•	What influences admission into residential aged care on discharge from hospital?
•	What happens to people after admission into residential aged care on discharge from hospital?
This report presents the first comprehensive statistical results from the linked database looking into these issues. 
Movement from hospital to residential aged care
Across Australia during 2001–02 there were 948,000 discharges from hospital after stays lasting at least 1 night for people aged 65 years and over. Of these, an estimated 9% (82,500) were separations into RAC, of which just over one-third (30,400) were for people who were newly admitted and two-thirds (52,000) were for people already living in RAC. The remaining 51,400 discharges were for people who died in hospital.
In 2001–02, there were 99,900 admissions into RAC, of which 20,900 (21%) were for transfers within residential care. Among the non-transfer admissions, more older people were admitted for permanent care via hospitals (21,800) than from the community (16,600). For respite care, admissions from the community accounted for almost four times as many respite admissions as those from hospital (32,000 compared with 8,600). Of the 20,900 people who changed their care arrangements, 8,000 admissions were for people changing from respite to permanent care and 11,700 admissions involved permanent residents transferring between aged care facilities.
Length of stay in hospital
People who returned to their home—either in the community or in residential care—after hospitalisation were highly likely to have left following acute care in hospital (93%), and were unlikely to have had more than one hospital episode related to their stay in hospital (around 10% of their hospital episodes started with an admission from within the hospital sector). These people also tended to have short hospital stays, with a median length of 4 days for the final hospital episode before discharge for those returning to the community and 6 days for those returning to RAC. 
On the other hand, people who were admitted into RAC on discharge from hospital were less likely to have been discharged straight from acute care in hospital, were more likely to have received rehabilitation or maintenance care, and were more likely to have started their last hospital episode with an admission from within the hospital system. For example, for people admitted into permanent care, 51% of episodes just prior to discharge from hospital were for acute care, 22% were for maintenance care and 11% were for rehabilitation. Furthermore, just over half of hospital episodes followed by admission into permanent care started with an admission from within the hospital sector.
People entering RAC had relatively long hospital episodes—with a median of 24 days for the final hospital episode prior to admission to permanent care and 14 days for those going to respite care.
Whether hospital stays prior to admission to residential care were unnecessarily long is difficult to gauge from current data (see discussion on refining the methods below). The most common principal diagnosis for people moving into permanent RAC was ‘Awaiting admission elsewhere’ (21%). This group had a median length of stay below that for all such transitions (20 days versus 24 days), but many may have had a longer stay in total due to transfers between care type or hospitals. The wait implied by such a diagnosis could have been caused by a number of factors, including requiring time for the patient and their family to decide on the necessity for residential care, the identification of available residential care suitable for the patient—both in terms of care needs and familial needs—and the time required to make the final choice. 
Propensity to enter residential aged care 
Overall, an estimated 30,400 hospital discharges were for people who were admitted into RAC straight after leaving hospital and 814,300 were for people who returned to live in the community. The most significant predictors of entry into RAC rather than a return to the community from hospital were:
•	length of stay in hospital (longer stays increased the probability of entering RAC)
•	principal and additional diagnoses—in particular, diagnoses of ‘Awaiting admission elsewhere’ and ‘Dementia and related disorders’ increased the probability of entering RAC
•	age (older age increased the probability of entering RAC)  
•	mode of hospital admission for exiting episode (admission from within the hospital system increased the probability of entering RAC) 
•	care type prior to hospital discharge (acute and rehabilitative care were associated with lower probabilities) 
•	marital status (being widowed or single increased the probability of entering RAC)
•	English proficiency group (high English proficiency was associated with higher probabilities).
The most significant factors associated with admission into permanent rather than respite RAC from hospital were: receiving palliative or maintenance care, or geriatric evaluation and management prior to hospital discharge; longer stays in hospital, a principal diagnosis of stroke, ‘Awaiting admission elsewhere’ or dementia; living in a major city and the state or territory of hospital admission. These last two indicate that regional aged care service provision and/or practices influenced the outcome.
Use of respite care 
Overall, admission to residential care from hospital was about two and one half times as likely to be for permanent care as for respite care (a ratio of permanent to respite admissions from hospital of 2.6 to 1). However, this varied with region. Admissions in Tasmania and Victoria were more likely to be for permanent care than in other jurisdictions (ratios of permanent to respite admissions of 7.5 to 1 and 4.5 to 1, respectively) while the ratio of permanent to respite admissions was lowest in the two territories (under 1.5 to 1). Across all regions examined, transitions from hospital for people from remote and very remote regions had the lowest permanent to respite admission ratio, with a fairly even split between permanent and respite admissions.
Examination of outcomes for people who were admitted into respite care from hospital showed that, in 2001–02, residential respite care was being used as transition care by people leaving hospital. Over one-half of people who moved from hospital to respite care had returned to live in the community within 12 weeks, while just 1% had transferred to permanent care, 6% had died in care, 11% had been discharged to hospital and 23% remained in respite care. For people admitted into respite care, the likelihood of a successful return to the community was greater for those admitted to low-level care than for those admitted to high-level care.
Survival following admission to permanent residential aged care
Once admitted into permanent RAC, few people leave to return to living in the community. Consequently, it is of interest to examine how long people survive once admitted to permanent care. Using survival analysis it is estimated that, for 2001–02, one-quarter of people admitted into permanent RAC died within just over 7 months of entering RAC and one-half died within 14 months. Two-fifths of people were still alive after 3 years. The most significant variable for predicting survival time after RAC admission was level of care needs on admission to RAC, followed by age, sex and whether the person was admitted into RAC from hospital. In particular, people admitted to RAC from hospital had lower expected survival times than others: one-quarter of people admitted from hospital were expected to die within 4 months of admission compared to within just over 7 months for all people admitted into permanent RAC.
The influence of health conditions on survival was examined by considering the survival of people admitted to permanent RAC from hospital. As for all people entering permanent RAC, the most significant variable for predicting survival time for people admitted from hospital was level of care needs on admission to RAC. However, health conditions were also influential, with both principal and additional hospital diagnoses affecting survival times.
People with selected health conditions
Outcomes for people following hospital discharge were looked at for people who had a diagnosis of dementia or stroke reported while in hospital, or who were in hospital as the result of injury due to a fall. The first of these conditions provides an example of a chronic and increasingly debilitating disease, while the second and third illustrate conditions which begin with an acute event that can affect functioning. 
The three selected conditions were individually reported in 2–3% of hospital episodes which ended with the patient returning to the community. In contrast, dementia was reported for 36% of hospital episodes that ended with admission to permanent care and stroke was reported for 13%. The prevalence of these conditions was less among discharges to respite care (22% for dementia and 5% for stroke). On the other hand, hospitalisation due to injury and a fall was more common among people who entered respite rather than permanent care after hospital (in 9% and 7% of such moves, respectively). 
The prevalence of stroke among people returning to permanent care after hospital was similar to that among those who returned to the community. However, the prevalence of dementia was much higher, with 26% of hospital episodes for those returning to care reporting a diagnosis of dementia (compared with 3% for those returning to the community). Hospitalisation due to injury and a fall was most common among people who were returning to residential care (10%).
The relative use of permanent and respite care among people who were admitted to residential care after hospital was different for the three conditions. A diagnosis of either dementia or stroke was associated with greater use of permanent care, with permanent to respite admission ratios of 4.2 to 1 and 6.4 to 1, respectively. People who had been in hospital because of a fall were more likely than others to be admitted into respite care, with one third of their admissions being for respite care (admission ratio of 2 permanent to 1 respite).
Refining the methods
The analyses in this report provide considerable insight into the hospital/aged care interface. With data developments in several areas, the flexibility and accuracy of analyses from linked hospital and residential aged care data could be further improved:
•	Linking contiguous hospital episodes for people to obtain whole-of-stay hospital data. This would allow better analysis of both hospital care and length of stay and would enhance the modelling of propensity to enter residential care. Methods similar to those used to link the hospital and RAC data for this study could be suitable and should be investigated.
•	Including mortality data. Linking residential care data with national mortality data would both allow better identification of death among this cohort and result in availability of cause of death data for analyses. Inclusion of this data would improve the accuracy of survival analyses. Linking national hospital and mortality data is not generally feasible due to data limitations.
•	Linking hospital and RAC data to identify moves from residential care into hospital. Methods very like those used to identify moves from hospital into RAC for this study could be used. This would allow bi-directional analyses, and would lead to a fuller picture of the interactions between hospitals and RAC.

1	Introduction
The interface between acute hospital care and residential aged care (RAC) has long been recognised as an important issue in aged care services research. Despite this, existing national data provide very poor information on the movement of clients between the residential and acute care sectors. Current national data sets on the two sectors are derived from routine administrative collections, and have been designed primarily to provide data on the specific program that they describe, rather than to examine program interfaces.
Over recent years, the Australian Institute of Health and Welfare (AIHW) has developed an event-based data linkage method to link national hospital morbidity data and RAC data, with the aim of improving national reporting on the acute care/aged care interface. For this report, national data were linked for 2001–02 to identify uni-directional movement straight from hospital to RAC. The resulting linked data provide a useful resource for investigating key policy questions, including:
•	What is the extent of movement between the two sectors?
•	Are older people staying too long in hospital before admission into residential aged care? 
•	What is leading to admission into residential aged care on discharge from hospital?
•	What happens to people after admission into residential aged care on discharge from hospital?
Before data linkage was undertaken for this study, approvals for the project were obtained from required ethics committees, and permission to use the hospital morbidity and RAC data was obtained from all data custodians (national, state and territory).
The report is structured as follows. This section provides background information on the data being used, a summary of the linkage method and national estimates of flow from the hospital to the RAC sector. Section 2 examines regional differences in movement from hospital to RAC. A detailed examination of the characteristics of people leaving hospital, and their hospital stay, is given in Section 3, while in Section 4 the characteristics of people entering RAC are considered. Propensity to be discharged from hospital into RAC and outcomes for people moving into RAC are examined in Section 5. The interaction between health conditions and transition outcome is investigated in Section 6, focusing on people affected by dementia, stroke, or injury due to a fall. Further data developments that could improve the flexibility and accuracy of analyses from linked hospital and RAC data are discussed in Section 7. Appendix A contains additional tables for the states and territories and appendices B to F contain technical details concerning the linkage process and analyses.
1.1	Event data
In this study, hospital episodes which lasted at least one night and which ended with the patient either leaving hospital or dying were linked to RAC events in which the person was either admitted to or returned to RAC. A brief description of the data is presented below, with more detailed information given in Appendix B.
The hospital data used in this study came from the National Hospital Morbidity Database (NHMD), and included data for both public and private hospital separations (see Box 1.1 for key terms). Same-day hospital episodes, in which people are admitted and discharged on the same day, were excluded as they are unlikely to be for transitions relating to either an admission into RAC or return to RAC following a period in hospital (although they could relate to a day procedure for a RAC resident).
If a patient transferred between hospitals or received more than one care type while they were in hospital, then their period of hospitalisation would have been reported as a number of contiguous episodes of care. Episodes that ended with the patient remaining in the hospital system were excluded from the analysis as they should not relate to movement from hospital into RAC. This meant that, even when a patient had more than one episode of care during a continuous period of care in hospital, only the characteristics of the last episode could be used for analysis. Whether or not a hospital stay is recorded as a single episode of care or as several episodes is affected by the implementation of casemix-based funding practices, which vary by state and territory and between urban and regional areas. The impact of this variation on reported care type and length of stay cannot be determined from the hospital data available for this report.
In 2001–02, across Australia there were almost 948,200 hospital separations for people aged 65 and over lasting at least one night and ending with the patient either dying (5.4%) or leaving the hospital (94.6%) (Table 1.1). 
Box 1.1:	Key terms in the hospital data
An episode of care for an admitted patient (or inpatient) can be: 
•	a total hospital stay—from admission into hospital to discharge from hospital or death, or
•	a portion of a hospital stay beginning and/or ending in a change of type of care (for example, from acute care to rehabilitation), or
•	a portion of a hospital stay beginning and/or ending in a transfer from/to another hospital.
Accordingly, for two types of discharges the patient remains within the hospital system. In a statistical discharge a patient changes from one hospital episode care type to another (for example, from acute care to rehabilitation). A patient may also transfer from one hospital to another.
An episode of care ends with a separation. Consequently, the terms episode of care and separation are used interchangeably.
An episode of care starting and ending on the same day is called a same-day episode/separation. All other episodes of care are called overnight episodes/separations. 
Length of stay is derived for episodes of care. The length of stay of an overnight episode is calculated by subtracting the date the patient is admitted from the date of separation and deducting any days the patient was on leave. A same-day episode is allocated a length of stay of 1 day.
The care type of an episode of care defines the overall nature of a clinical service provided to an admitted patient during an episode of care (see Box 3.2 for details).
Both a principal diagnosis and additional diagnoses are assigned for each episode of care. The principal diagnosis is that diagnosis established after study to be chiefly responsible for occasioning the episode of admitted patient care. Other conditions that contribute to the complexity and cost of patient treatment are recorded in the NHMD as additional diagnoses; additional diagnoses may therefore not be inclusive of all comorbid conditions experienced by the patient.
Diagnosis codes are classified according to the ICD-10-AM Edition 2 diagnosis classification (see Appendix C). In this report, for ease of expression an ICD-10-AM chapter (which is a set of related diagnoses) is referred to as a condition group.
Source: AIHW 2003a, AIHW: Karmel et al. 2007b.
Table 1.1: 	Hospital separations for people aged 65+, by state/territory, 2001–02
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	
	Number	
Died in hospital	17,874	13,740	9,048	4,297	4,636	1,074	591	105	51,365	
Left hospital	290,841	230,361	170,749	79,392	88,941	23,839	10,625	2,048	896,796	
Total	308,715	244,101	179,797	83,689	93,577	24,913	11,216	2,153	948,161	
	Per cent	
Died in hospital	5.8	5.6	5.0	5.1	4.9	4.3	5.2	4.9	5.4	
Left hospital	94.2	94.4	95.0	94.9	95.1	95.7	94.8	95.1	94.6	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Notes
1.	Age is as at time of hospital admission. 
2.	Table excludes same-day hospital episodes, statistical discharges and transfers to other hospitals.

The RAC data were derived from the Department of Health and Ageing’s Aged and Community Care Management Information System (ACCMIS). There are three main ways a client may enter or re-enter RAC (Box 1.2):
•	as a new admission, for either permanent or respite care. A permanent admission may be preceded by pre-entry leave of up to 7 days
•	returning from hospital leave after a permanent resident has had a period in hospital. Hospital leave is provided for hospital stays lasting at least one night
•	returning from social leave after a permanent resident has had a period away from the RAC facility to visit family and/or friends.
The RAC data for this analysis included all RAC permanent and respite admissions and hospital and social leave events for the year of interest, totalling slightly more than 215,100 events for people aged 65 and over (Table 1.2). Nationally, less than half (46%) of the RAC events involved admissions, with the remainder being for people already in permanent care, that is the events were either hospital or social leave from RAC. However, this split varied across jurisdictions, ranging from 56% for admissions in the Northern Territory to 41% in Western Australia. The relative use of permanent and respite RAC also varied with jurisdiction.
Box 1.2:	Key terms in RAC
For a person to be able to access permanent and respite RAC, assessment by an Aged Care Assessment Team (ACAT) is required. An ACAT approval remains valid for 12 months. If a person’s care needs change to the extent that a different level or type of care is required, they may be reassessed within that period. 
A person may be admitted for permanent care in a RAC facility, with the RAC facility becoming the person’s place of usual residence. A permanent admission may be preceded by pre-entry leave of up to 7 days. This leave gives a prospective resident time to make arrangements to enter an aged care home or to transfer from one home to another home in a distant location. Care is provided on a 
high-care or low-care basis, according to care needs appraised using the Resident Classification Scale (RCS), which is also used for determining the daily basic subsidy paid by the Australian Government. RCS categories 1–4 equate to high care and 5–8 equate to low care.
A person may be admitted for respite care in a RAC facility. Residential respite care is important both for people who need a higher level of care just for the short term and as a component of the carer support system, whether for emergency care or to provide a ‘break’ while carers attend to other affairs or take a holiday. A person can receive up to a total of 63 days of subsidised respite care in any financial year. This total covers respite admissions to all Australian Government-funded RAC services. However, if a person needs more than 63 days of respite care in the financial year, the ACAT may in some circumstances approve extension periods of 21 days at a time. Care is provided on a 
high-care or low-care basis, according to care needs appraised during the ACAT assessment.
A permanent RAC resident can take unlimited days of leave for the purpose of receiving hospital treatment, termed hospital leave. Hospital leave is provided for hospital stays lasting at least one night. Extended hospital leave is where a resident has hospital leave for a continuous period of 30 days or more. In this case, the daily basic subsidy paid to the RAC facility is reduced by two RCS categories.
The Aged Care Act 1997 provides social leave for residents of aged care homes of up to 52 days of overnight absences per financial year. This enables residents to spend each weekend, or 2 days plus one overnight absence per week, with their families if they wish to do so without losing their place at the RAC facility.
Sources: AIHW 2007a:chapter 3, DoHA 2005.

Table 1.2:	RAC events by event type for people aged 65+, by state/territory, 2001–02
RAC event type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	
	Number	
Permanent admission	20,961	14,644	10,084	4,739	5,470	1,337	559	100	57,894	
Respite admission	15,385	9,986	7,228	3,190	3,813	1,471	740	200	42,013	
Subtotal 	36,346	24,630	17,312	7,929	9,283	2,808	1,299	300	99,907	
Hospital leave, ending with:										
Return from hospital	19,299	13,390	11,712	5,732	6,330	1,083	557	98	58,201	
Discharge to hospital	652	659	418	323	103	15	8	—	2,178	
Death in hospital	2,270	1,543	1,288	598	622	110	63	16	6,510	
Subtotal	22,221	15,592	13,418	6,653	7,055	1,208	628	114	66,889	
Social leave	17,508	9,393	10,740	4,604	4,000	1,351	589	126	48,311	
Total	76,075	49,615	41,470	19,186	20,338	5,367	2,516	540	215,107	
	Per cent	
Permanent admission	27.6	29.5	24.3	24.7	26.9	24.9	22.2	18.5	26.9	
Respite admission	20.2	20.1	17.4	16.6	18.7	27.4	29.4	37.0	19.5	
Subtotal 	47.8	49.6	41.7	41.3	45.6	52.3	51.6	55.6	46.4	
Hospital leave, ending with:										
Return from hospital	25.4	27.0	28.2	29.9	31.1	20.2	22.1	18.1	27.1	
Discharge to hospital	0.9	1.3	1.0	1.7	0.5	0.3	0.3	—	1.0	
Death in hospital	3.0	3.1	3.1	3.1	3.1	2.0	2.5	3.0	3.0	
Subtotal	29.2	31.4	32.4	34.7	34.7	22.5	25.0	21.1	31.1	
Social leave	23.0	18.9	25.9	24.0	19.7	25.2	23.4	23.3	22.5	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Notes
1.	Age is as at time of RAC entry. 
2.	Table includes admissions within the year, and RAC leave events (including those ending in death in hospital or discharge to hospital) with a leave end date during the period 1 July 2001 – 30 June 2002.
3.	Outcome of hospital leave is based on event dates and reason of discharge from RAC.
4.	State/territory relates to the RAC outlet entered by the client.
1.2	Linkage method
Data linkage is a statistical tool that can be used to link data from different sources, thereby expanding the types of statistical investigations that can be carried out (including analysis of movement over time) without increasing the reporting load of service providers or requiring special surveys. Data linkage of records for individuals is commonly carried out using detailed demographic data, including name and/or a person identification number. While neither name nor a common person identification number are available for linking data from the hospital and RAC sectors, some demographic data are available. In addition, information on transition dates, that is entry and exit dates, is available for all periods of hospitalisation and residential care. In recent years, the AIHW has developed and refined an event-based method that uses such information to link transition events (AIHW 2003b; AIHW: Karmel 2004; AIHW: Karmel & Rosman 2007; Karmel & Gibson 2007). The effectiveness of this method has been established both through theoretical analysis and direct comparison with a well-established name-based linkage strategy (AIHW: Karmel 2004; AIHW: Karmel & Rosman 2007). 
For this analysis, linkage was undertaken using an event-based matching strategy that identifies links between events using demographic variables in conjunction with relevant event date information and event descriptors available on the NHMD and ACCMIS databases. The linkage strategy matched hospital separations to the relevant RAC entries. Delays of up to 2 days between hospital exit and RAC entry were allowed when identifying transition events—with the exception of admissions with arranged RAC pre-entry leave, where gaps of up to 7 days were allowed (see Box 1.2).
To protect the privacy of individuals, the linkage was carried out by the AIHW using the Institute’s protocol Data linkage and protecting privacy: a protocol for linking between two or more data sets held within the Australian Institute of Health and Welfare (AIHW 2006). Key aspects of this protocol are that data linkage is undertaken using purpose-specific linkage data sets that contain only the data required for establishing and validating links, and that analysis files do not contain identifying data. A detailed description of the linkage process, including an overview of the linkage protocols, is contained in Appendix B. 
Comparisons with a name-based linkage method have shown that the event-based linkage strategy results in few false matches and that linkage sensitivities are consistent across RAC event types (around 90%; see Table B.3). Consequently, the linked data provides a strong basis for examining transitions between hospital and RAC. In addition, while event-based links understate the total number of transitions, the linked data can be used to measure relativities between the different types of transitions from hospital into RAC.
Using event-based linkage a total of 76,179 transitions from hospital to RAC were identified (Table 1.3). Nearly two-thirds of these links (63%) were for people returning to permanent RAC, with the overwhelming majority of these relating to people on RAC hospital leave. Among the remaining links, admissions to permanent care out-numbered those to respite care by more than two to one (26% versus 10% of links).
1.3	Approximate estimates of flow
Measures of link quality show that event-based linkage more often tends to miss matches than make false matches (Table B.3). As a consequence, event-based linkage underestimates the total number of transitions and so cannot be used without adjustment to measure the volume of flow from hospital to RAC. While the Western Australian project was a one-off study limited to one year and one state, it was felt important to produce some national estimates for the overall flow of older people from hospital to RAC. To this end, approximate estimates were calculated using adjustment factors based on the results from the Western Australian study (Table 1.3) (see Appendix B for method).
The flow of people can be examined from two viewpoints: 
(a)	looking at the destination of people who are leaving hospital (that is, hospital separations) 
(b)	looking at the source of people who are entering permanent or respite RAC (that is, RAc admissions).
As stated before, during 2001–02 there were nearly 948,200 hospital separations for stays lasting at least one night for people aged 65 years and older. Of these hospital separations, an estimated 8.7% (82,500) were discharges into RAC, either as returns to RAC or as new admissions (Table 1.3). The majority of these transitions were due to people living in RAC having episodes of hospitalisation (approximately 52,000, or 5.5% of episodes), rather than the result of people being admitted into RAC (approximately 30,400 or 3.2% of episodes). An additional 5.4% of separations from hospital ended with the death of the patient, with people returning to the community or going to other care arrangements for the remaining 86% of hospital separations.
On the other hand, during 2001–02 there were just over 99,900 admissions into RAC, either from the community, from hospital or through within-RAC transfers. It is estimated that almost one-third (30%) of these admissions were from hospital, of which nearly 
three-quarters related to permanent care (21.8/30.4 = 72%). Almost one-half of admissions came from the community (49%), and among these about one-third (16.6/48.7 = 34%) were for permanent care. The remaining one-fifth (21%) of admissions related to transfers within RAC—predominantly into permanent care. 
From the perspective of the residential aged care sector, the above results mean that more older people made the transition to residential care on a permanent basis via hospitals (21,800, or 57% of non-transfer permanent admissions) than from the community (16,600). A further 19,500 permanent admissions related to transfers within RAC. Quite a different pattern was seen for respite admissions, with admissions from the community accounting for almost four times as many respite admissions as those from hospital (32,000 compared with 8,600). Transfers into respite care were a relatively small group (1,375 admissions). Overall, 8,000 RAC transfer admissions were for people moving from respite to permanent care and 11,700 involved permanent residents transferring between aged care homes (Table 1.3, note f).
Table 1.3:	Movement types for hospital separations and RAC entries, people aged 65+, 2001–02
	Estimates	
Type of movement	Unadjusted		Adjusted	
	Number 	Per cent		Number 	Per cent	
Hospital separations		
Return to permanent RAC(a)(b)								
From hospital leave	47,011	5.0	61.7		50,600	5.3	61.4	
From hospital while on social leave	1,309	0.1	1.7		1,400	0.1	1.7	
Subtotal	48,320	5.1	63.4		52,000	5.5	63.1	
To permanent RAC(a)(b)(c)	20,117	2.1	26.4		21,800	2.3	26.4	
To respite RAC(b)(c)	7,742	0.8	10.2		8,600	0.9	10.4	
Subtotal to RAC	76,179	8.0	100.0		82,500	8.7	100.0	
To community/other(d)	820,617	86.5	. .		814,300	85.9	. .	
Died in hospital(d)	51,365	5.4	. .		51,365	5.4	. .	
Total separations	948,161	100.0	. .		948,161	100.0	. .	
RAC admissions		
Permanent admissions								
From hospital to permanent RAC(a)(c)	20,125	20.1	. .		21,800	21.8	. .	
From community into permanent RAC(e)	18,261	18.3	. .		16,600	16.6	. .	
Transfer into permanent RAC(e)(f)	19,508	19.5	. .		19,508	19.5	. .	
Subtotal 	57,894	57.9	. .		57,894	57.9	. .	
Respite admissions								
From hospital to respite RAC(a)(c)	7,744	7.8	. .		8,600	8.6	. .	
From community into respite RAC(e)	32,894	32.9	. .		32,000	32.1	. .	
Transfer into respite RAC(e)(f)	1,375	1.4	. .		1,375	1.4	. .	
Subtotal 	42,013	42.1	. .		42,013	42.1	. .	
Total admissions	99,907	100.0	. .	 	99,907	100.0	. .	
(a)	Links to a permanent admission on the same or next day as the end of a period of hospital leave for the same person have been reassigned as linking to the hospital leave. This affected 266 links to permanent admissions.
(b)	Based on linked hospital and RAC records. Same-day and next-day re-admissions into permanent RAC are treated as transfers and so have been combined into a single period of care when identifying returns to RAC after hospital leave.
(c)	Estimates of transitions between hospital and RAC vary slightly depending on whether movements from hospital or into RAC are being examined due to transitions occurring across either the beginning or end of the financial year.
(d)	Unlinked hospital separations for people leaving the hospital system. Deaths are based on reported hospital mode of separation.
(e)	Transfers between RAC facilities. 
(f)	41% of transfers into permanent RAC were from respite RAC and 87% of transfers into respite RAC were from respite RAC.
Notes
1.	Age is as at time of hospital admission or RAC admission. 
2.	Table excludes same-day hospital episodes, statistical discharges and transfers to other hospitals.
3.	Adjusted numbers for movements from hospital are rounded to the nearest hundred (see Appendix B). 

1.3.1	Approach to analysis of movements
In this report we analyse the movement of people from hospital in two ways:
•	by looking at where people go following discharge from hospital
•	by comparing the characteristics of people making the various transitions.
As seen above, the event-based linkage strategy underestimates the number of transitions from hospital to RAC by around 8% (see Table 1.3). Consequently, within any 
sub-population, the proportion of all hospital discharges identified as relating to a move to RAC is underestimated and is not directly comparable with that of another sub-population. Furthermore, movement between the two sectors can only occur if the patient has not died in hospital, and so transitions are only of interest for those that leave hospital alive. Therefore, to aid interpretation, for sub-populations of interest the proportion of hospital separations not ending in death that related to transitions into RAC is presented, using a range to indicate the level of accuracy in these estimates of flow. However, because similar proportions of the three types of transitions to RAC were identified (see Table B.3), the relative sizes of the three transition types into RAC are compared directly without adjustment.
Using the above approach, the movement of people from hospital is therefore examined by first identifying deaths in hospital. Approximate estimates of flow are then derived to obtain an estimated range of the proportion of live separations from hospital that resulted in the patient moving into RAC (minimum = unadjusted estimate, maximum = estimate obtained by applying the maximum adjustment in Table B.4 to all identified transition records). After that, the proportion of transitions into RAC relating to returns to care and new admissions are examined using unadjusted numbers (see sections 2, 3 and 6). This process is illustrated in Figure 1.1. 
When looking at admissions into RAC, unadjusted estimates understate the relative importance of admissions from hospital compared with admissions from the community. Therefore, to better gauge the mix of admissions from hospital and from the community, adjusted estimates are presented for a small number of classifications only (see Section 4).
Comparisons of the characteristics of people making the various transitions are undertaken using distributions based on unadjusted figures. Results from the linkage comparison study using Western Australian data indicated that such analyses are unlikely to be affected by the level of misclassification of transition type present in the current study (see Table B.3 and AIHW: Karmel & Rosman 2007: sections 7 and 8).
Figure 1.1:	Schematic outlining the approach to analysis of movements
Flowchart diagram. 
2	Regional movements 
The numbers of hospital separations and RAC admissions for the states and territories largely reflected their population sizes (Table 2.1). However, closer inspection of the figures indicates that there were differences between the jurisdictions in the movement patterns from hospital to RAC.
As discussed previously, because the event-based linkage strategy underestimates the number of transitions from hospital to RAC, we present an estimated range for the proportion of all live hospital discharges that were transitions to RAC (see Section 1.3.1 and Box 2.1). Tasmania and the Northern Territory had relatively few transitions into RAC from hospital—around 6% to 7% of all live separations from hospital (Table 2.2). On the other hand, New South Wales, Queensland, Western Australia and South Australia had relatively high proportions moving to RAC, with discharges to RAC estimated at around 9% to 10% of all live discharges from hospital. Victoria and the Australian Capital Territory had rates between these two groups. 
The mix of types of transitions to RAC also varied with jurisdiction (Figure 2.1). The split between returns and admissions showed some variation, with the percentage of admissions from hospital compared to returns to care ranging from around 31% for Western Australia and the Australian Capital Territory to 40% for New South Wales (Table 2.2). The ratio of permanent to respite admissions varied more widely with jurisdiction (Table 2.3), although for all states and territories there were more moves into permanent RAC than into respite care. For Tasmania and Victoria there was a relatively high use of permanent care: for every respite admission in Tasmania from hospital there were over 7 permanent care admissions from hospital while in Victoria there were over 4. For the other states and territories the ratio of permanent to respite admissions was below the national average of 2.6 to 1, with South Australia and the two territories having ratios of less than 2 to 1.
Box 2.1:	Technical note on interpretation of unadjusted numbers of transitions
The event-based linkage strategy underestimates the number of transitions from hospital to RAC by around 8% (see Table 1.3). It is not currently possible to accurately adjust estimates of transition types for sub-populations, such as age groups. Consequently, within any sub-population of interest, the proportion of all hospital discharges identified as relating to a move to RAC is underestimated and is not directly comparable with that of another group. However, because similar proportions of the three types of transitions to RAC are identified (Table B.3), the relative sizes of the three transition types into RAC can be compared. Therefore, to aid interpretation, an estimated range of the proportion of hospital separations relating to all transitions to RAC is presented for sub-populations under discussion and, within sub-populations, the relativities of the three types of transitions into RAC are given (see, for example, tables 2.2 and 2.3).
When looking at admissions into RAC, unadjusted estimates understate the relative importance of admissions from hospital compared with admissions from the community. Therefore, to better gauge the mix of admissions from hospital and from the community, adjusted estimates are presented for a small number of classifications only (see Section 4).
Source: Section 1.3.1.

Figure 2.1:	Movement into RAC from hospital by jurisdiction
Vertical bar chart showing Transactions into RAC (%) on y-axis and state on x-axis. Key shows ‘Returning to permanent RAC’, ‘To respite RAC’ and ‘To permanent RAC’.
Source: Table 2.2.

As expected from the results for the states and territories, the numbers of hospital separations by remoteness of region largely reflected the population size of each region (Table 2.4). However, people from more remote regions were less likely than those from less remote regions to end their stay in hospital with a discharge to RAC (Table 2.5). For example, around 10% of hospital episodes (excluding those ending in death) for people who lived in a major city before hospitalisation were discharged to RAC compared with under 6% for those from remote and very remote regions. 
The variation in the mix of transitions into permanent and respite RAC was less across region types than between the states and territories (Table 2.6). People living in major cities before going into hospital had the highest relative transition into permanent care, with just over 3 permanent admissions from hospital for every respite admission. However, this ratio decreased with remoteness such that relatively high numbers of those from outer regional, remote and very remote areas moved into respite care.
Whether people were moving between regions to access appropriate hospital care can be gauged by comparing the region of usual residence of the patient with the region of the hospital (Table 2.7). Not unexpectedly, across all movement types, increasing remoteness of a person’s usual residence was associated with an increased likelihood of being treated in a hospital in a less remote area. Nearly all (98%) hospital separations for people whose usual residence was in a major city were associated with treatment in a hospital in a major city. In contrast, approximately three-quarters of separations for people usually living in inner and outer regional areas were related to hospitals in those areas, and around 60% of separations for people who usually lived in remote and very remote areas were from hospitals in those regions. 
Generally, inter-regional travel to get hospital care was less common for people moving into or returning to RAC than for people returning to the community (Table 2.7), particularly among people living in regional and remote areas (for people living in major cities, there was little difference). For example, among those who usually lived in inner regional areas, 85% of separations for people moving into or returning to RAC were from hospitals in the same region, compared with 75% for people returning to the community. A similar difference was seen for people usually living in outer regional, remote and very remote areas.
Table 2.1:	Movement from hospital and into RAC for people aged 65+, by movement type and state/territory, 2001–02 (unadjusted)
Movement type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Hospital separations	Number (unadjusted)	
To RAC		
Return to permanent RAC(a)	15,836	10,639	10,088	4,790	5,470	902	515	80	48,320	
To permanent RAC  	7,279	5,443	3,455	1,439	1,858	486	135	22	20,117	
To respite RAC 	3,265	1,203	1,410	693	993	65	95	18	7,742	
Subtotal	26,380	17,285	14,953	6,922	8,321	1,453	745	120	76,179	
To community/other	264,461	213,076	155,796	72,470	80,620	22,386	9,880	1,928	820,617	
Died in hospital	17,874	13,740	9,048	4,297	4,636	1,074	591	105	51,365	
Total separations	308,715	244,101	179,797	83,689	93,577	24,913	11,216	2,153	948,161	
RAC admissions		
Permanent admissions		
From hospital to permanent RAC  	7,275	5,470	3,442	1,440	1,858	487	133	20	20,125	
From community into permanent RAC	5,966	4,877	3,424	1,742	1,498	529	181	44	18,261	
Transfer into permanent RAC 	7,720	4,297	3,218	1,557	2,114	321	245	36	19,508	
Subtotal 	20,961	14,644	10,084	4,739	5,470	1,337	559	100	57,894	
Respite admissions										
From hospital to respite RAC  	3,279	1,204	1,401	693	992	66	91	18	7,744	
From community into respite RAC	11,551	8,520	5,575	2,390	2,690	1,369	619	180	32,894	
Transfer into respite RAC 	555	262	252	107	131	36	30	2	1,375	
Subtotal 	15,385	9,986	7,228	3,190	3,813	1,471	740	200	42,013	
Total admissions	36,346	24,630	17,312	7,929	9,283	2,808	1,299	300	99,907	
	Row per cent	
All hospital separations	32.6	25.7	19.0	8.8	9.9	2.6	1.2	0.2	100.0	
All RAC admissions	36.4	24.7	17.3	7.9	9.3	2.8	1.3	0.3	100.0	
Population 65+, 31 December 2001(b)	35.2	25.6	17.4	8.6	9.0	2.7	1.1	0.3	100.0	
(a)	Includes both links to RAC hospital leave (47,319) and links to RAC social leave (1,317). 
(b)	Total population excludes external territories (ABS 2001a).
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups.
2.	Age is as at time of hospital admission or RAC event.
3.	State/territory refers to hospital or RAC service.
Table 2.2:	Summary of movements from hospital into RAC for people aged 65+, by movement type, Australia, 2001–02
	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
	Row per cent		Est’d min %	Est’d max %	
New South Wales	60.0	27.6	12.4	100.0	26,380	                9.1 	10.1	
Victoria	61.6	31.5	7.0	100.0	17,285	                7.5 	8.3	
Queensland	67.5	23.1	9.4	100.0	14,953	                8.8 	9.7	
Western Australia	69.2	20.8	10.0	100.0	6,922	                8.7 	9.7	
South Australia	65.7	22.3	11.9	100.0	8,321	                9.4 	10.4	
Tasmania	62.1	33.4	4.5	100.0	1,453	                6.1 	6.8	
Australian Capital Territory	69.1	18.1	12.8	100.0	745	                7.0 	7.8	
Northern Territory	66.7	18.3	15.0	100.0	120	                5.9 	6.5	
All	63.4	26.4	10.2	100.0	. .	                8.5 	9.4	
Total separations (number)	48,320	20,117	7,742	. .	76,179	                    896,796	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission.
3.	State/territory refers to hospital.
Table 2.3:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, Australia, 2001–02 (unadjusted hospital separations)
	To permanent RAC	To respite
 RAC	Total 	Permanent : respite admissions	
	Number (unadjusted hospital separations)	Ratio	
New South Wales	             7,279 	             3,265 	           10,544 	2.2	:	1	
Victoria	             5,443 	             1,203 	             6,646 	4.5	:	1	
Queensland	             3,455 	             1,410 	             4,865 	2.5	:	1	
Western Australia	             1,439 	                693 	             2,132 	2.1	:	1	
South Australia	             1,858 	                993 	             2,851 	1.9	:	1	
Tasmania	                486 	                  65 	                551 	7.5	:	1	
Australian Capital Territory	                135 	                  95 	                230 	1.4	:	1	
Northern Territory	                  22 	                  18 	                  40 	1.2	:	1	
All	           20,117 	             7,742 	           27,859 	2.6	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition 
groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	State/territory refers to hospital.
Table 2.4:	Hospital separations for people aged 65+, by movement type and remoteness of usual residence prior to admission into hospital, 2001–02 (unadjusted)
Movement type	Major cities	Inner regional	Outer 
regional	Remote 	Very remote	Australia	
To RAC	Number (unadjusted)	
Return to permanent RAC	     32,526 	     10,532 	      4,707 	        442 	          95 	         48,302 	
To permanent RAC	     14,073 	       4,242 	      1,641 	        107 	          33 	         20,096 	
To respite RAC	       4,510 	       2,027 	      1,042 	        112 	          37 	           7,728 	
Subtotal	        51,109 	        16,801 	         7,390 	            661 	            165 	        76,126 	
To community/other	   501,819 	   202,326 	    96,345 	    12,095 	      4,529 	       817,114 	
Died in hospital	     32,927 	     11,681 	      5,761 	        664 	        220 	         51,253 	
Total separations	       585,855 	       230,808 	      109,496 	        13,420 	          4,914 	       944,493 	
	Row per cent	
All hospital separations	62.0	24.4	11.6	1.4	0.5	100.0	
Population 65+, 30 June 2002(a)	64.7	23.3	10.5	1.2	0.4	100.0	
(a)	Total population excludes external territories (ABS 2002).
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the ABS (ABS 2001b). 
4.	3,667 records were missing valid postcodes for remoteness coding (53 for movements into RAC, 112 for deaths in hospital and 3,502 for separations to the community). 
Table 2.5:	Summary of movements from hospital into RAC for people aged 65+, by movement type and remoteness of usual residence prior to admission into hospital, Australia, 2001–02 
	Returning to permanent RAC	To permanent RAC	To 
respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
	Row per cent		Est’d min %	Est’d max %	
Major cities	63.6	27.5	8.8	100.0	51,109	             9.2 	           10.3 	
Inner regional	62.7	25.2	12.1	100.0	16,801	             7.7 	             8.5 	
Outer regional	63.7	22.2	14.1	100.0	7,390	             7.1 	             7.9 	
Remote	66.9	16.2	16.9	100.0	661	             5.2 	             5.8 	
Very remote	57.6	20.0	22.4	100.0	165	             3.5 	             3.9 	
All	63.5	26.4	10.2	100.0	. .	             8.5 	             9.5 	
Total separations (number)	48,302	20,096	7,728	. .	76,126	                 893,240	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission.
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the ABS (ABS 2001b). 
4.	53 records relating to movements into RAC were missing valid postcodes for remoteness coding. 
Table 2.6:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by remoteness of usual residence prior to admission into hospital, Australia, 2001–02 (unadjusted hospital separations)
Remoteness area	To permanent RAC	To respite
 RAC	Total	Permanent : 
respite admissions	
	Number (unadjusted hospital separations)	Ratio	
Major cities	         14,073 	              4,510 	        18,583 	3.1	:	1	
Inner regional	           4,242 	              2,027 	          6,269 	2.1	:	1	
Outer regional	           1,641 	              1,042 	          2,683 	1.6	:	1	
Remote	              107 	                 112 	             219 	1.0	:	1	
Very remote	                33 	                   37 	               70 	0.9	:	1	
All	         20,096 	              7,728 	        27,824 	2.6	:	1	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by 
the ABS (ABS 2001b). 
4.	53 records relating to movements into RAC were missing valid postcodes for remoteness coding. 
Table 2.7:	Hospital separations for people aged 65+: remoteness of usual residence prior to admission into hospital, by remoteness of hospital and movement type, 2001–02 (unadjusted)
	Remoteness of hospital			
Movement type/remoteness of usual residence prior to hospital	Major
cities	Inner regional	Outer regional	Remote and very remote	Total	N	
Return to permanent RAC	Row per cent		
Major cities	99.0	0.9	—	—	100.0	24,139	
Inner regional	14.1	84.6	1.3	—	100.0	7,389	
Outer regional	2.8	13.3	83.3	0.5	100.0	4,128	
Remote and very remote	2.7	3.1	15.4	78.7	100.0	512	
All	69.3	19.5	10.0	1.2	100.0	. .	
Total separations (number)	25,069	7,045	3,625	429	. .	36,168	
To permanent RAC							
Major cities	98.7	1.2	0.1	—	100.0	11,157	
Inner regional	13.6	83.8	2.5	—	100.0	3,295	
Outer regional	2.6	16.3	80.2	0.9	100.0	1,507	
Remote and very remote	<7.3	<3.6	29.9	64.2	100.0	137	
All	71.4	19.6	8.3	0.6	100.0	. .	
Total separations (number)	11,500	3,149	1,344	103	. .	16,096	
To respite RAC							
Major cities	97.5	2.3	0.2	—	100.0	2,952	
Inner regional	9.4	87.9	2.6	—	100.0	1,410	
Outer regional	1.7	12.7	84.7	0.8	100.0	943	
Remote and very remote	<3.5	<3.5	20.3	75.5	100.0	143	
All	55.6	26.3	16.0	2.1	100.0	. .	
Total separations (number)	3,031	1,431	870	116	. .	5,448	
All to RAC							
Major cities	98.8	1.1	0.1	—	100.0	38,248	
Inner regional	13.4	84.8	1.8	—	100.0	12,094	
Outer regional	2.6	13.9	82.8	0.7	100.0	6,578	
Remote and very remote	2.8	2.8	18.8	75.6	100.0	792	
All	68.6	20.1	10.1	1.1	100.0	. .	
Total separations (number)	39,600	11,625	5,839	648	. .	57,712	
					(continued)	
Table 2.7 (continued): 	Hospital separations for people aged 65+: remoteness of usual residence prior to admission into hospital, by remoteness of hospital and movement type, 2001–02 (unadjusted)
	Remoteness of hospital			
Movement type/remoteness of usual residence prior to hospital	Major cities	Inner regional	Outer regional	Remote and very remote	Total	N	
To community/other							
Major cities	98.2	1.4	0.3	0.1	100.0	290,477	
Inner regional	22.9	75.0	2.0	0.2	100.0	121,867	
Outer regional	9.0	19.2	70.5	1.4	100.0	72,884	
Remote and very remote	10.0	5.0	20.1	65.0	100.0	14,044	
All	64.3	22.1	11.5	2.1	100.0	. .	
Total separations (number)	321,047	110,175	57,464	10,586	. .	499,272	
Died in hospital							
Major cities	98.9	1.0	0.1	—	100.0	25,096	
Inner regional	18.8	79.3	1.9	—	100.0	9,129	
Outer regional	6.6	17.4	74.9	1.1	100.0	5,124	
Remote and very remote	9.4	5.3	18.9	66.4	100.0	852	
All	67.0	20.9	10.4	1.6	100.0	. .	
Total separations (number)	26,950	8,422	4,195	634	. .	40,201	
All							
Major cities	98.3	1.4	0.3	0.1	100.0	353,821	
Inner regional	21.8	76.1	2.0	0.1	100.0	143,090	
Outer regional	8.3	18.7	71.7	1.3	100.0	84,586	
Remote and very remote	9.6	4.9	19.9	65.6	100.0	15,688	
All	64.9	21.8	11.3	2.0	100.0	. .	
Total separations (number)	387,597	130,222	67,498	11,868	. .	597,185	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of 
transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the 
ABS (ABS 2001b). 
4.	Postcodes of private hospitals are not recorded on the NHMD. 350,976 records were excluded due mostly to missing hospital 
and, in a small number of records, missing postcode of usual residence.

3	Leaving hospital
In 2001–02, nearly two-thirds (63%) of separations from hospital for people aged 65 and over were from public hospitals (Table 3.1). Proportionally fewer people were discharged from private hospitals into RAC than from public hospitals: 5–6% of discharges from private hospitals (excluding deaths) were associated with entry into RAC compared with just over 10% from public hospitals (Table 3.2). For people moving from a public hospital to RAC there were three times as many admissions into permanent RAC as into respite RAC; for moves from private hospital the ratio of permanent to respite care admissions was much lower at 
1.7 to 1 (Table 3.3).
People who returned to the community on leaving hospital were less likely than those who went to residential care to have been in a public hospital, with 61% of returns to the community relating to discharges from a public hospital (Table 3.1). In contrast, 
three-quarters of hospital episodes ending with the patient returning to permanent RAC were in public hospitals, with 80% of transitions into permanent RAC originating from a public hospital and 70% of moves into respite care.
In the following discussion, a number of characteristics of patients and their hospital care are examined, including age and sex profiles, length of stay in hospital, type of care received and medical reason for hospital admission. Variation in movement patterns are also examined by remoteness of the patient’s usual residence.
Table 3.1: 	Hospital separations for people aged 65+, by movement type and hospital sector, Australia, 2001–02 (unadjusted)
	Hospital sector		
Movement type	Public	Private	Total	N	
To RAC	Row per cent		
Return to permanent RAC	           74.9 	         25.1 	        100.0 	       48,320 	
To permanent RAC	           80.1 	         19.9 	        100.0 	       20,117 	
To respite RAC	           70.4 	         29.6 	        100.0 	        7,742 	
Subtotal 	           75.8 	         24.2 	        100.0 	       76,179 	
To community/other	           61.0 	         39.0 	        100.0 	     820,617 	
Died in hospital	           78.4 	         21.6 	        100.0 	       51,365 	
All	           63.2 	         36.8 	 100.0 	. .	
Total separations (number)	      598,941 	    349,220 	. .	     948,161 
	
Notes		
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	Sector relates to hospital type, not admission status.
4.	In 2001–02, 13% of separations in public hospitals were for private patients and 4% of separations in private hospitals were for public patients (AIHW 2003a). 

Table 3.2:	Summary of movements from hospital into RAC for people aged 65+, by movement type and hospital sector, Australia, 2001–02
Hospital sector	Returning to permanent RAC	To permanent RAC	To 
respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
	Row per cent		Est’d min %	Est’d max %	
Public	62.7	27.9	9.4	100.0	57,729	               10.3 	            11.5 	
Private	65.9	21.7	12.4	100.0	18,450	                 5.5 	              6.1 	
All	63.4	26.4	10.2	100.0	. .	                 8.5 	              9.4 	
Total separations (number)	48,320	20,117	7,742	. .	76,179	                   896,796	
Notes		
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
3.	Sector relates to hospital type, not admission status.
4.	In 2001–02, 13% of separations in public hospitals were for private patients and 4% of separations in private hospitals were for public patients (AIHW 2003a). 

Table 3.3:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by hospital sector, Australia, 2001–02 (unadjusted hospital separations)
Hospital sector	To permanent RAC	To respite
 RAC	Total	Permanent : respite admissions	
	Number (unadjusted hospital separations)	Ratio	
Public	            16,108 	            5,451 	           21,559 	3.0	:	1	
Private	              4,009 	            2,291 	             6,300 	1.7	:	1	
All	20,117	7,742	           27,859 	2.6	:	1	
Notes		
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on 
identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	Sector relates to hospital type, not admission status.
4.	In 2001–02, 13% of separations in public hospitals were for private patients and 4% of separations in private 
hospitals were for public patients (AIHW 2003a). 

3.1	Characteristics of patients leaving hospital
Among people aged 65 and over, hospital use increases with age (AIHW: Karmel et al. 2007b). Consequently, the age profile of patients leaving hospital is older than that of the general population, with people aged 80 and over making up 25% of the older population (65+) in 2001–02 but contributing 37% of hospital separations for this group (Table 3.6). 
As would be expected, older hospital patients were more likely than younger patients to be associated with a move to RAC. For people aged 65–79, under 2% of hospital episodes (not including deaths) ended with discharge to RAC compared with over 40% of episodes for people aged 95 and over (Table 3.4). Overall, around 4% of live hospital separations for people aged 65–79 ended with the patient being discharged to RAC compared with 17% to 19% for people aged 80 and over (Table 3.4). For all age groups women were more likely than men to be discharged to RAC, with this difference being more marked at older ages.
Over the age of 80, as both men and women get older, movement from hospital to RAC was more and more likely to relate to a return to permanent RAC (Table 3.4). This trend was more prominent for women than for men, with the proportion of transitions relating to return to permanent care increasing from under 60% for women aged less than 80 up to 73% for women aged 95 and over. For men, again around 60%of transitions into RAC for men aged less than 80 were returns to permanent care, with the proportion rising to 67% for transitions for men aged 95 and over.
The ratio of permanent to respite admissions following a period in hospital increased with age for women aged 75 and over (Table 3.5). A similar but weaker trend was observed among admissions for men. For the oldest group (95+) the ratio of permanent to respite admissions was 4.1 to 1 for women and 3.6 to 1 for men.
Reflecting the above transition patterns, hospital separations ending with either the patient returning to the community or dying were more likely to be for younger people than other hospital episodes (Figure 3.1 and Table 3.6). Two-thirds (67%) of transitions back to the community and almost one-half (48%) of separations ending with the patient’s death were for people aged 65–79 compared with 27% of all transitions into RAC. As expected, people returning to permanent RAC had an older age profile than those admitted into permanent RAC who, in turn, had an older profile compared with those going into respite care: 75%, 70% and 67% of such transitions, respectively, were for people aged 80 and over. 
Reflecting the greater longevity of women, transition groups with high proportions of people aged 80 and over tended to have relatively few men (Table 3.6, Figure 3.1). The difference in the age profiles of men and women was particularly noticeable for people moving from hospital into RAC. For example, 16% of returns to permanent RAC for men were for people aged 90 and over compared with 26% of such transitions for women; the corresponding figures for admissions into permanent RAC were 13% for men and 22% for women.

Figure 3.1:	Age and sex profile by post-hospital destination
Two Vertical bar charts showing hospital separations (%) on y -axes and ‘%80+’ and ‘% male’ on x-axes. Key shows ‘returning to permanent RAC’, ‘to permanent RAC’, ‘to respite RAC’, ‘died in hospital’ and ‘to community/other’.
Source: Table 3.6.

Table 3.4:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Australia, 2001–02
Sex/age	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–69	60.4	28.2	11.3	100.0	1,413	1.6	1.8	
70–74	59.3	29.5	11.1	100.0	3,051	2.9	3.2	
75–79	56.4	31.6	12.0	100.0	5,127	4.8	5.4	
Subtotal 65–79	57.9	30.5	11.6	100.0	         9,591 	3.2	3.6	
80–84	58.0	31.0	11.1	100.0	6,545	8.7	9.7	
85–89	61.3	29.3	9.5	100.0	5,838	14.6	16.3	
90–94	64.6	26.3	9.1	100.0	3,024	24.0	26.7	
95+	67.3	25.6	7.1	100.0	703	32.1	35.7	
Subtotal 80+	60.8	29.2	10.0	100.0	       16,110 	12.4	13.8	
All	59.7	29.7	10.6	100.0	. .	6.0	6.6	
Total (number)	15,354	7,629	2,718	. .	25,701	                 430,224	
Women						 	 	
65–69	59.4	28.6	12.1	100.0	1,228	1.7	1.9	
70–74	57.6	29.1	13.3	100.0	3,024	3.3	3.7	
75–79	60.3	26.9	12.8	100.0	7,054	6.6	7.4	
Subtotal 65–79	59.5	27.7	12.8	100.0	       11,306 	4.2	4.6	
80–84	62.9	25.5	11.5	100.0	12,300	13.1	14.6	
85–89	67.3	23.5	9.1	100.0	14,911	22.3	24.8	
90–94	70.2	22.8	7.0	100.0	9,168	32.9	36.6	
95+	72.5	22.1	5.4	100.0	2,793	42.9	47.7	
Subtotal 80+	67.0	23.9	9.1	100.0	       39,172 	20.1	22.3	
All	65.3	24.7	10.0	100.0	. .	10.8	12.0	
Total (number)	32,966	12,488	5,024	. .	50,478	              466,572	
All						 	 	
65–69	59.4	28.6	12.1	100.0	2,641	1.6	1.8	
70–74	57.6	29.1	13.3	100.0	6,075	3.1	3.4	
75–79	60.3	26.9	12.8	100.0	12,181	5.7	6.4	
Subtotal 65–79	58.8	29.0	12.3	100.0	       20,897 	3.7	4.1	
80–84	62.9	25.5	11.5	100.0	18,845	11.1	12.4	
85–89	67.3	23.5	9.1	100.0	20,749	19.4	21.6	
90–94	70.2	22.8	7.0	100.0	12,192	30.1	33.5	
95+	72.5	22.1	5.4	100.0	3,496	40.2	44.7	
Subtotal 80+	65.2	25.4	9.4	100.0	       55,282 	17.0	18.9	
All	65.3	24.7	10.0	100.0	. .	8.5	9.4	
Total separations (number)	48,320	20,117	7,742	. .	76,179	                896,796	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
3.	State/territory tables are in Appendix A.
Table 3.5:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Australia, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To
 respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–69	399	160	559	2.5	:	1	
70–74	901	340	1,241	2.7	:	1	
75–79	1,621	615	2,236	2.6	:	1	
Subtotal 65–79	2,921	1,115	4,036	2.6	:	1	
80–84	2,026	724	2,750	2.8	:	1	
85–89	1,708	553	2,261	3.1	:	1	
90–94	794	276	1,070	2.9	:	1	
95+	180	50	230	3.6	:	1	
Subtotal 80+	4,708	1,603	6,311	2.9	:	1	
All	7,629	2,718	10,347	2.8	:	1	
Women							
65–69	351	148	499	2.4	:	1	
70–74	879	403	1,282	2.2	:	1	
75–79	1,901	901	2,802	2.1	:	1	
Subtotal 65–79	3,131	1,452	4,583	2.2	:	1	
80–84	3,141	1,417	4,558	2.2	:	1	
85–89	3,508	1,364	4,872	2.6	:	1	
90–94	2,090	640	2,730	3.3	:	1	
95+	618	151	769	4.1	:	1	
Subtotal 80+	9,357	3,572	12,929	2.6	:	1	
All	12,488	5,024	17,512	2.5	:	1	
All							
65–69	750	308	1,058	2.4	:	1	
70–74	1,780	743	2,523	2.4	:	1	
75–79	3,522	1,516	5,038	2.3	:	1	
Subtotal 65–79	6,052	2,567	8,619	2.4	:	1	
80–84	5,167	2,141	7,308	2.4	:	1	
85–89	5,216	1,917	7,133	2.7	:	1	
90–94	2,884	916	3,800	3.1	:	1	
95+	798	201	999	4.0	:	1	
Subtotal 80+	14,065	5,175	19,240	2.7	:	1	
All	20,117	7,742	27,859	2.6	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of 
transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	State/territory tables are in Appendix A.

Table 3.6:	Hospital separations for people aged 65+, by movement type, age and sex, Australia, 
2001–02 (unadjusted)
	Age at hospital admission			
Sex / movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	5.6	11.8	18.8	24.7	23.3	12.7	3.1	100.0	15,354	
To permanent RAC	5.2	11.8	21.2	26.6	22.4	10.4	2.4	100.0	7,629	
To respite RAC	5.9	12.5	22.6	26.6	20.3	10.2	1.8	100.0	2,718	
Subtotal	5.5	11.9	19.9	25.5	22.7	11.8	2.7	100.0	25,701	
To community/other	21.7	25.1	25.1	17.0	8.4	2.4	0.4	100.0	404,523	
Died in hospital	12.1	18.7	23.7	21.2	16.2	6.5	1.6	100.0	26,989	
All	20.2	24.0	24.7	17.7	9.7	3.1	0.6	100.0	. .	
Total separations (number)	92,381	109,646	112,887	80,991	44,322	14,374	2,612	. .	457,213	
Women	Row per cent		
To RAC			
Return to permanent RAC	2.2	5.3	12.9	23.5	30.5	19.5	6.1	100.0	32,966	
To permanent RAC	2.8	7.0	15.2	25.2	28.1	16.7	4.9	100.0	12,488	
To respite RAC	2.9	8.0	17.9	28.2	27.1	12.7	3.0	100.0	5,024	
Subtotal	2.4	6.0	14.0	24.4	29.5	18.2	5.5	100.0	50,478	
To community/other	17.4	21.2	23.9	19.6	12.5	4.5	0.9	100.0	416,094	
Died in hospital	8.5	13.1	19.4	22.0	21.4	11.8	3.8	100.0	24,376	
All	15.4	19.3	22.7	20.2	14.7	6.3	1.5	100.0	. .	
Total separations (number)	75,699	94,557	111,290	99,132	72,063	30,779	7,428	. .	490,948	
All	Row per cent		
To RAC			
Return to permanent RAC	3.3	7.4	14.8	23.9	28.2	17.4	5.2	100.0	48,320	
To permanent RAC	3.7	8.8	17.5	25.7	25.9	14.3	4.0	100.0	20,117	
To respite RAC	4.0	9.6	19.6	27.7	24.8	11.8	2.6	100.0	7,742	
Subtotal	3.5	8.0	16.0	24.7	27.2	16.0	4.6	100.0	76,179	
To community/other	19.5	23.1	24.5	18.3	10.5	3.4	0.6	100.0	820,617	
Died in hospital	10.4	16.0	21.7	21.6	18.7	9.1	2.6	100.0	51,365	
All	17.7	21.5	23.6	19.0	12.3	4.8	1.1	100.0	. .	
Total separations (number)	168,080	204,203	224,177	180,123	116,385	45,153	10,040	. .	948,161	
Population 65+, 31 December 2001(a)									
Men	31.2	27.9	21.1	12.1	7.7	. .	. .	100.0	1,088,715	
Women	25.6	24.3	21.4	15.1	13.6	. .	. .	100.0	1,368,596	
All	28.1	25.9	21.3	13.8	11.0	. .	. .	100.0	2,457,311	
(a)	Oldest age group includes people aged 85+. Total population excludes external territories (ABS 2001a).
Notes	
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	State/territory tables are in Appendix A.
3.2	Length of stay
Two measures are commonly used to gauge length of stay: the arithmetic mean and the median (that is, that length of stay with half of the values being smaller and half larger). For all groups, the mean length of episodes can be affected by a relatively small number of very long episodes. Therefore, consideration of both measures is informative. Note, however, that for both methods the estimate resulting from the current NHMD data understates the total length of stay in hospital to the extent that people change care type or transfer within the hospital system (see Box 3.1).
Box 3.1:	Technical note on estimates of length of stay in hospital
For two types of hospital separations the patient remains within the hospital system: when a patient changes from one hospital episode care type to another and when a patient transfers from one hospital to another (Box 1.1). Because a person identifier is not available on the NHMD it is not possible to string together a person’s episodes of hospital care into a single stay. Consequently, measures of length of hospital episode understate the total length of stay in hospital to the extent that people change care type or transfer within the hospital system.
The effect of movement within the hospital system on estimates of length of stay for people leaving hospital is likely to be different for the different transition groups because the likelihood of the exit episode being the only one related to the period in hospital varies with transition group. Overall, in 2001–02, 12% of hospital separations for older people ending with discharge from the hospital system had started either with a transfer from another hospital (9%) or with a change in hospital care type (3%) (Table A.1). Within transition group:
•	around 10% of hospital separations ending with discharge from the hospital system for people returning to their home (either in the community or in permanent RAC) had more than one hospital episode during their period in hospital
•	51% of the hospital episodes ending with the person being admitted into permanent RAC had begun with the person already in hospital (18% beginning with a transfer and 33% beginning with a change in care type)
•	32% of the hospital episodes ending with the person being admitted into respite RAC had begun with the person already in hospital (17% beginning with a transfer and 15% beginning with a change in care type) 
•	23% of episodes ending with the death of the patient had previous contiguous episodes. 
These figures indicate that estimates of length of stay for people who were admitted into RAC will be more affected by within-hospital changes than those who returned home. Consequently, actual differences were likely to have been greater than the estimated differences.
In addition, the implementation of casemix-based funding practices vary by state and territory and between urban and regional areas. This will affect whether or not a hospital stay is recorded as a single episode of care or as several episodes. The impact of this variation on reported care type and length of stay cannot be determined from the hospital data available for this report.

The time spent in hospital for people aged 65 and over varied considerably according to the type of transition from hospital (Figure 3.2). People returning to the community from hospital, on average, had the shortest lengths of stay, with a median time of 4 days in hospital (mean of 7.1 days), compared with 7 days for people who died in hospital (mean of 17.3 days) (tables 3.7 and 3.8). People making the transition from the community into RAC via hospital tended to spend more time in hospital, with people going into permanent RAC having longer stays than those accessing respite care (median stay of 24 days compared with 14, and means of 38.2 and 19.5 days, respectively). People returning to permanent RAC had lengths of stay comparable with those for people who returned to the community following their period in hospital. 
That some people spent much longer than others in hospital is reflected in the considerable differences between the mean and median length of stay for some transition groups. In particular, some people were admitted into RAC after long stays in hospital: in at least 10% of cases, people moving into permanent RAC stayed in hospital for 73 days or more while 90% of episodes for those returning to RAC after hospital leave lasted 19 days or less (tables 3.8 and 3.9, Figure 3.2). 
Figure 3.2:	Length of stay by post-hospital destination
Two vertical bar charts showing Length of hospital episode (days) on y-axes and ‘Median’ and ‘90th percentile’ on x-axes. Key shows ‘to community/other’, ‘returning to permanent RAC’, ‘died in hospital’, ‘to respite RAC’ and ‘to permanent RAC’.
Source: tables 3.8 and 3.9.

While there was some evidence that women tended to have longer hospital episodes than men (Table 3.7), the differences were not great. On the other hand, for some transition groups, length of stay varied with age. In particular, for people who were admitted into permanent RAC both the median and 90th percentile for length of stay decreased as age increased: people aged 65–69 years who moved into permanent RAC had a median length of stay of 26 days compared with 21 days for people aged 95 and over (90th percentiles of 91 days and 62 days) (tables 3.8 and 3.9). In contrast, among people who returned to the community, older people tended to have longer hospital episodes than younger people (medians of 3 days versus 
6 days for the youngest and oldest age groups, respectively).
Table 3.7:	Hospital separations for people aged 65+: mean length of stay, by movement type, age and sex, Australia, 2001–02 (unadjusted)
	Age at hospital admission		
Movement type 	65–69	70–74	75–79	80–84	85–89	90–94	95+	 All	
Men	Mean (days)	
Return to permanent RAC	8.5	8.4	8.1	8.3	7.8	7.6	7.4	8.1	
To permanent RAC	45.1	43.1	41.6	40.2	34.9	33.3	32.2	39.0	
To respite RAC	19.9	20.0	21.1	19.3	18.9	16.2	17.1	19.4	
To community/other	5.8	6.2	6.7	7.3	7.8	8.5	8.4	6.6	
Died in hospital	15.5	14.0	14.9	14.9	17.6	17.6	17.1	15.4	
All	6.4	7.0	7.8	8.8	10.0	11.0	11.4	7.8	
Total separations (number)	92,381	109,646	112,887	80,991	44,322	14,374	2,612	457,213	
Women	Mean (days)	
Return to permanent RAC	9.4	9.3	8.9	8.8	8.5	8.4	8.0	8.6	
To permanent RAC	57.4	47.5	42.0	37.6	35.8	31.2	33.7	37.8	
To respite RAC	19.4	22.2	19.9	19.3	19.9	17.8	16.9	19.6	
To community/other	6.1	6.9	7.5	8.3	8.9	9.8	10.3	7.6	
Died in hospital	16.3	17.1	21.4	19.0	18.2	22.8	19.6	19.3	
All	6.7	7.7	8.8	10.0	11.0	12.3	12.9	9.1	
Total separations (number)	75,699	94,557	111,290	99,132	72,063	30,779	7,428	490,948	
All	Mean (days)	
Return to permanent RAC	8.9	8.8	8.6	8.6	8.3	8.2	7.9	8.4	
To permanent RAC	50.8	45.3	41.8	38.6	35.5	31.7	33.4	38.2	
To respite RAC	19.7	21.2	20.4	19.3	19.6	17.4	17.0	19.5	
To community/other	6.0	6.5	7.1	7.8	8.5	9.4	9.8	7.1	
Died in hospital	15.8	15.2	17.6	16.9	17.9	20.8	18.8	17.3	
All	6.5	7.3	8.3	9.5	10.6	11.9	12.5	8.5	
Total separations (number)	168,080	204,203	224,177	180,123	116,385	45,153	10,040	948,161	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission.
3.	State/territory tables are in Appendix A (by sex only).

Table 3.8:	Hospital separations for people aged 65+: median length of stay, by movement type, age and sex, Australia, 2001–02 (unadjusted)
	Age at hospital admission		
Movement type 	65–69	70–74	75–79	80–84	85–89	90–94	95+	 All	
Men	Median (days)	
Return to permanent RAC	5.5	6	6	6	5	5	5	5	
To permanent RAC	28	26	26	25	24	22	21	25	
To respite RAC	14	13.5	15	14	13	12	12.5	14	
To community/other	3	4	4	4	5	5	5	4	
Died in hospital	7	7	8	8	8	7	7	8	
All	3	4	4	5	5	6	6	4	
Total separations (number)	92,381	109,646	112,887	80,991	44,322	14,374	2,612	457,213	
Women	Median (days)	
Return to permanent RAC	6	6	6	6	6	6	6	6	
To permanent RAC	24	23	24	23	23	22	21.5	23	
To respite RAC	13.5	14	14	14	14	13.5	14	14	
To community/other	4	4	5	5	6	6	6	5	
Died in hospital	8	8	7	7	7	7	7	7	
All	4	4	5	5	6	7	7	5	
Total separations (number)	75,699	94,557	111,290	99,132	72,063	30,779	7,428	490,948	
All	Median (days)	
Return to permanent RAC	6	6	6	6	6	6	5	6	
To permanent RAC	26	25	25	24	23	22	21	24	
To respite RAC	14	14	14	14	14	13	14	14	
To community/other	3	4	4	5	5	6	6	4	
Died in hospital	7	7	8	8	7	7	7	7	
All	4	4	5	5	6	6	6	5	
Total separations (number)	168,080	204,203	224,177	180,123	116,385	45,153	10,040	948,161	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission. 
3.	State/territory tables are in Appendix A (by sex only).

Table 3.9:	Hospital separations for people aged 65+: 90th percentile of length of stay, by movement type, age and sex, Australia, 2001–02 (unadjusted)
	Age at hospital admission		
Movement type 	65–69	70–74	75–79	80–84	85–89	90–94	95+	 All	
Men	90th percentile (days)	
Return to permanent RAC	18	18	17	18	17	17	17	17	
To permanent RAC	92	85	81	79	70	64	67.5	77	
To respite RAC	43.5	44	41	42	36	35	36.5	40	
To community/other	12	13	14	16	17	18	19	14	
Died in hospital	30	29	31	30	31	31	32	30	
All	13	14	16	19	21	23	25	16	
Total separations (number)	92,381	109,646	112,887	80,991	44,322	14,374	2,612	457,213	
Women	90th percentile (days)	
Return to permanent RAC	21	20	20	19	19	19	17	19	
To permanent RAC	89	86	75	72	66	61	59	69	
To respite RAC	43	47	40	40	40	36	32	40	
To community/other	13	14	16	18	20	21	22	16	
Died in hospital	33	33	32	32	31	30	29	32	
All	14	16	18	21	23	26	26	19	
Total separations (number)	75,699	94,557	111,290	99,132	72,063	30,779	7,428	490,948	
All	90th percentile (days)	
Return to permanent RAC	20	19	19	19	18	19	17	19	
To permanent RAC	91	85	78	75	67	62	62	73	
To respite RAC	43	46	41	40	39	36	32	40	
To community/other	12	14	15	17	19	20	21	15	
Died in hospital	31	30	31.5	31	31	30.5	30	31	
All	13	15	17	20	22	25	26	18	
Total separations (number)	168,080	204,203	224,177	180,123	116,385	45,153	10,040	948,161	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission.
3.	State/territory tables are in Appendix A (by sex only).
3.3	Hospital care type
People can receive a range of types of care while in hospital, depending on the main clinical intent of the hospital episode. These include acute care, rehabilitative care, palliative care, geriatric evaluation and management (GEM), psychogeriatric care and maintenance care (see Box 3.2 for descriptions). 

Box 3.2:	 Care types for admitted patients
The care type of a hospital episode (see Box 1.1) defines the overall nature of a clinical service provided to an admitted patient during an episode of care (admitted care), or the type of service provided by the hospital for boarders or during posthumous organ procurement (other care). Care types of relevance to older patients include:
•	Acute care, where the clinical intent or treatment goal is either to cure illness or provide definitive treatment of injury, perform surgery, to relieve symptoms of illness or injury (non-palliative), reduce severity of an illness or injury, protect against exacerbation and/or complication of an illness or injury which could threaten life or normal function; and/or perform diagnostic or therapeutic procedures.
•		Rehabilitation care occurs when a person with a disability is participating in a multidisciplinary program aimed at an improvement in functional capacity, retraining in lost skills and/or change in psychosocial adaptation.
•	Palliative care occurs when a person’s condition has progressed beyond the stage where curative treatment is effective and attainable, or where the person chooses not to pursue curative treatment. Palliation provides relief of suffering and enhancement of quality of life for such a person. Intervention such as radiotherapy, chemotherapy and surgery are considered to be part of the palliative episode if they are undertaken specifically to provide symptomatic relief.
•	Geriatric evaluation and management (GEM), where the clinical intent or treatment goal is to maximise health status and/or optimise the living arrangements for a patient with  multi-dimensional medical conditions associated with disabilities and psychosocial problems, and who is usually (but not always) an older patient.
•	Psychogeriatric care, in which the clinical intent or treatment goal is improvement in health, modification of symptoms and enhancement in function, behaviour and/or quality of life for a patient with an age-related organic brain impairment with significant behavioural or late onset psychiatric disturbance or a physical condition accompanied by severe psychiatric or behavioural disturbance.
•	Maintenance care, in which the clinical intent or treatment goal is prevention of deterioration in the functional and current health status of a patient with a disability or severe level of functional impairment. 
•	Other care, in which the clinical intent does not meet the criteria for any of the above, and includes ‘Organ procurement—posthumous’ and ‘Hospital boarder’.
Source: AIHW 2003a.

Some hospital care types were more likely than others to be associated with a transition to RAC (Table 3.10). People discharged from acute care were the least likely to be discharged to RAC, with under 10% of such hospital episodes (excluding deaths) ending in this way. At the other extreme, around half of the patients discharged from maintenance care moved directly to RAC. Patients in GEM and psychogeriatric care also had high rates of transition to RAC (28%–31% and 34%–38%, respectively). Compared with these patients, those in rehabilitation or palliative care were considerably less likely to move to RAC (12%–14% of live separations).
Table 3.10:	Summary of movements from hospital into RAC for people aged 65+, by hospital care type, Australia, 2001–02
Hospital care type	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
	Row per cent		Est’d min %	Est’d max %	
Acute	73.7	16.9	9.4	100.0	60,612	7.4	8.2	
Rehabilitation	41.4	40.0	18.6	100.0	5,264	12.4	13.8	
Palliative	27.7	60.4	12.0	100.0	618	12.4	13.7	
GEM	23.3	70.3	6.4	100.0	2,367	28.2	31.4	
Psychogeriatric	48.9	39.9	11.2	100.0	466	33.7	37.5	
Maintenance	5.3	81.1	13.6	100.0	5,345	49.9	55.6	
Other	3.3	90.8	6.0	100.0	1,277	35.3	39.2	
All 	63.4	26.4	10.2	100.0	. .	8.5	9.5	
Total separations (number)	48,152 	20,064 	7,733 	. .	75,949	                890,693	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
3.	Care types Newborn care, Organ procurement—posthumous and Hospital boarder were excluded from the table (1 case).
4.	230 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 
226 of these were from private hospitals.
Nearly three-quarters (74%) of acute care episodes that ended with the patient going to RAC were for people returning to permanent care (Figure 3.3, Table 3.10). This proportion was much higher than that for any other care type, with psychogeriatric and rehabilitative care having the next highest proportions (49% and 41%, respectively). Only around one quarter of palliative care and GEM episodes involving transitions from hospital to RAC were for people already in permanent care. Very few episodes of maintenance care (5% of transitions to RAC) were for people returning to permanent RAC, with 81% of transitions from this care type relating to admissions into permanent care. Transitions into RAC from ‘other’ types of hospital care were predominantly for people going into permanent RAC (91%). Care types with a high ratio of permanent to respite admissions were GEM (11.0 to 1), maintenance care (6.0 to 1) and palliation (5.0 to 1) (Table 3.11). 
People leaving hospital to return to the community or to permanent RAC had similar care type profiles, with 93% of their hospital episodes involving acute care and 5% being for rehabilitation (Table 3.12). However, reflecting the differing proportions that related to transitions to RAC seen above for the various care types, care profiles were quite different for the other transition groups. Acute care accounted for just over half (51%) of episodes ending with the patient entering permanent RAC, with maintenance care being the next most common care type (22%). Rehabilitative care was also quite common (11%). At 8%, GEM was at least four times more common among this transition group than for any other group. Hospital episodes ending with the patient going to RAC for respite care were more likely to have been for acute care (73%) and less likely to have been for maintenance care (9%) than those ending with admission to permanent RAC; slightly more received rehabilitative care (13%) before being discharged.
Figure 3.3:	Movement into RAC from hospital by hospital care type 
Vertical bar chart showing transactions into RAC (%) on y-axis and hospital care type on x-axis. Key shows ‘returning to permanent RAC’, ‘to respite RAC’ and ‘to permanent RAC’.
Source: Table 3.10.

Length of stay varied both with care type and with post-hospital destination within care type (Table 3.13). As expected, acute care episodes tended to be shorter than other types (mean 6.8 days, median 4 days), with palliative care also being relatively short (mean 13.8 days, median 8 days). Psychogeriatric and maintenance care episodes were, on average, much longer than other episodes, particularly the former with a mean length of 64.2 days and median of 28 days.
Within care type, there were two broad patterns of length of stay depending on post-hospital destination. For acute care, rehabilitation, palliative care and GEM episodes, those ending with admission into RAC tended to be longer than other episodes, with patients entering permanent care having had longer stays than those going for respite care (Table 3.13). For psychogeriatric and maintenance care (and, to a lesser extent, ‘other’ care), the longest episodes tended to be for those who died in hospital, with episodes ending in permanent RAC admission being the next longest. Episodes ending with the patient returning to their usual residence in the community or in RAC had similar length of stay patterns across hospital care type.
Table 3.11:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by hospital care type, Australia, 2001–02 (unadjusted hospital separations)
Remoteness area	To permanent RAC	To respite
 RAC	Total	Permanent : respite admissions	
	Number (unadjusted hospital separations)	Ratio	
Acute	       10,241 	         5,675 	       15,916 	1.8	:	1	
Rehabilitation	         2,105 	            978 	         3,083 	2.2	:	1	
Palliative	            373 	              74 	            447 	5.0	:	1	
GEM	         1,665 	            151 	         1,816 	11.0	:	1	
Psychogeriatric	            186 	              52 	            238 	3.6	:	1	
Maintenance	         4,335 	            727 	         5,062 	6.0	:	1	
Other	         1,159 	              76 	         1,235 	15.3	:	1	
All	20,064	7,733	       27,797 	2.6	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition 
groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	Care types Newborn care, Organ procurement—posthumous and Hospital boarder were excluded from the table (1 case).
4.	230 records with unknown care type were excluded from the table. All related to separations from Tasmanian hospitals; 
226 of these were from private hospitals.
Table 3.12:	Hospital separations for people aged 65+, by hospital care type and movement type, Australia, 2001–02 (unadjusted)
Hospital care type	Returning to permanent RAC	To permanent RAC	To
 respite RAC	To community/
other	Died in hospital	All	N	
	Column per cent		
Acute	92.8	51.0	73.4	93.1	77.6	91.2	        858,930 	
Rehabilitation	4.5	10.5	12.6	4.6	1.2	4.6	          43,121 	
Palliative	0.4	1.9	1.0	0.5	16.9	1.5	          13,678 	
GEM	1.1	8.3	2.0	0.7	1.2	1.0	            9,008 	
Psychogeriatric	0.5	0.9	0.7	0.1	0.1	0.2	            1,439 	
Maintenance	0.6	21.6	9.4	0.7	2.5	1.3	          12,004 	
Other	0.1	5.8	1.0	0.3	0.5	0.4	            3,873 	
Total 	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	48,125	20,064	7,733 	814,744 	51,360 	. .	942,053	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
3.	Care types Newborn care, Organ procurement—posthumous and Hospital boarder were excluded from the table (1 case).
4.	6,107 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
5.	State/territory tables are in Appendix A.
Table 3.13:	Hospital separations for people aged 65+: mean, median and 90th percentile of length of stay, by hospital care type and movement type, Australia, 2001–02 (unadjusted)
Hospital care type	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	To community/
other	Died in hospital	All	N	
	Mean (days)		
Acute	7.6	28.6	16.4	6.1	11.7	6.8	858,930	
Rehabilitation	19.4	39.7	28.1	19.7	24.0	20.9	43,121	
Palliative	9.1	33.3	22.0	11.5	14.2	13.8	13,678	
GEM	20.4	47.2	24.2	22.2	26.8	27.1	9,008	
Psychogeriatric	31.8	129.4	47.0	46.6	291.6	64.2	1,439	
Maintenance	10.6	50.5	27.0	28.5	176.4	51.9	12,004	
Other	16.8	48.1	35.1	17.2	85.4	31.2	3,873	
All	8.4	38.2	19.5	7.1	17.3	8.5	. .	
	Median (days)		
Acute	5	21	12	4	7	4	858,930	
Rehabilitation	17	30	23	15	16	15	43,121	
Palliative	6	22	15	8	8	8	13,678	
GEM	16	35	19.5	15	18	18	9,008	
Psychogeriatric	25	51	35.5	26	60	28	1,439	
Maintenance	7	22	14	9	31	14	12,004	
Other	9	26	24.5	7	23	12	3,873	
All	6	24	14	4	7	5	. .	
	90th percentile (days)		
Acute	16	57	34	13	27	15	858,930	
Rehabilitation	35	76	51	38	51	41	43,121	
Palliative	20	77	59	23	34	31	13,678	
GEM	39	99	49	46	55	57	9,008	
Psychogeriatric	67	333	100	74	718	99	1,439	
Maintenance	23	92	56	41	461	79	12,004	
Other	n.p.	95	74	37	165	65	3,873	
All	19	73	40	15	31	18	. .	
Total hospital (number)	48,152	20,064	7,733	814,744	51,360	. .	942,053	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission. 
3.	Care types Newborn care, Organ procurement—posthumous and Hospital boarder were excluded from the table (1 case).
4.	6,107 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
3.4	Hospital diagnosis 
During a hospital episode, information about the health conditions that cause or contribute to admission, or which influence treatment, is recorded on the patient record. Of all the diagnoses recorded, the principal diagnosis is defined as that found to be chiefly responsible for the episode of care. However, where multiple complex health conditions are present, it may be difficult to identify one single condition that caused admission to hospital, and the interaction of multiple health conditions, medication use, and social factors can contribute significantly to the need for hospitalisation among older people and to the complexity and cost of treatment. In addition, the relatively high prevalence of multiple hospital episodes relating to a stay in hospital by people newly moving to residential care affects the examination of health conditions causing hospitalisation for these people. In some cases the initial reason for the hospitalisation of a person who was discharged into residential care may not be represented in the available data, with the principal diagnosis for the hospital episode immediately prior to the move either being different from that which caused the initial hospitalisation or indicating care needs rather than a specific health condition.
Noting these limitations, in the following discussion the principal diagnoses for older patients making various transitions are examined, with diagnoses combined into 18 groups corresponding to diagnosis chapters, or condition groups, in the International Classification of Diseases 10th revision Australian Modification (ICD-10-AM, 2nd edition). In the following analysis, groups of conditions are referred to using abbreviated names to aid the flow of discussion; names showing more fully the conditions included in the group are used in the tables (for example Diseases of the musculoskeletal system and connective tissues is referred as musculoskeletal diseases in the discussion). Appendix C contains a list of conditions included in the ICD-10-AM edition 2 chapters, and classification codes are provided in tables where appropriate (see Table 3.14 for an example).
Overall, the four most common condition groups (diseases of the circulatory, digestive and respiratory systems, and neoplasms, that is, tumours and cancers) accounted for 50% of overnight hospital episodes ending with the patient leaving hospital (Table 3.16). The proportion of hospital separations (excluding deaths) that ended with discharge to RAC varied considerably across groups of conditions, ranging from under 5% (for example, for patients in hospital with a principal diagnosis of neoplasm) to over 70%—for patients with a principal diagnosis of awaiting admission elsewhere (Table 3.14). Apart from this latter group, only principal diagnoses among mental and behavioural disorders were associated with more than 15% of live hospital separations ending with discharge to RAC (21%–24%).
Among people moving from hospital to RAC, some condition groups were more likely than others to be associated with admission into residential care as opposed to return to permanent care (Table 3.14). As expected, nearly all hospital–RAC transition episodes for people awaiting admission elsewhere related to an admission into RAC (96%); the remaining 4% (191 transitions) were for people already in RAC who moved to a different RAC facility on leaving hospital. Hospital episodes for patients with a principal diagnosis related to factors influencing health status, to mental and behavioural disorders or to the nervous system (the last two of which include dementia conditions) were commonly associated with admission into RAC, with less than half of these transition hospital episodes being for people already in permanent RAC. On the other hand, over 85% of transition episodes with a principal diagnosis related to the digestive system, blood disorders or eye problems were for people already in permanent residential care.
Patients waiting for admission elsewhere had the highest ratio of permanent to respite care admissions (8.5 to 1) (Table 3.15). Conditions associated with an above average ratio of permanent to respite care admissions included mental and behavioural disorders and diseases of the nervous system (3.1 and 3.2 to 1, respectively).
Reflecting both the overall prevalence of diagnoses and propensity to be associated with a move to RAC, the frequency of particular disease groups varied considerably with 
post-hospital destination (Figure 3.4). For example, principal diagnoses in the four most common condition groups overall accounted for 75% of episodes ending with the death of the patient, compared with about one-quarter (24%) for patients admitted to permanent RAC on leaving hospital. 
There were several key differences in the principal diagnosis profiles of the transition groups (Table 3.16, Figure 3.4). Of particular interest is the high proportion of episodes that ended with a permanent admission to RAC which had ‘Awaiting admission elsewhere’ as their principal diagnosis (21%). This diagnosis was next most common among patients who later moved to respite care (7% of episodes). Other factors influencing health status were also commonly given as the principal diagnosis for hospital episodes ending with admission to RAC (17–20%). Diagnoses in this group include health services for examinations, investigations and specific procedures and ‘persons with potential hazards’ (see Appendix C). Relatively high proportions of hospital episodes for people who returned to permanent RAC or who moved to respite care (13% and 11%, respectively, compared with 7% overall) were admitted to hospital primarily as the result of injury or poisoning.
The average length of hospital episode varied with the principal diagnosis on hospital admission (tables 3.17, 3.18 and 3.19). For example, in 2001–02 patients with an eye condition as the principal diagnosis tended to have very short stays (mean 1.8 days, median 1 day) while those in hospital with mental or behavioural disorders had long stays (mean 26.0 days, median 12 days). However, in general, irrespective of the condition leading to hospital admission, people who were admitted to RAC after leaving hospital had longer hospital episodes than others, while those who either returned to the community or to permanent RAC had similar length of stay patterns. Those who died in hospital on average had a length of stay between these two groups. There were, however, some exceptions. Patients with a principal diagnosis of ‘Awaiting admission elsewhere’ who either returned to the community or died in hospital tended to have similar or longer hospital episodes than those who were admitted into RAC. 
For a number of condition groups the 90th percentile was similar or higher for people who died in hospital as that for those who moved to RAC; that is, a significant proportion had long stays in hospital before dying. Condition groups where this pattern occurred were factors influencing health status (including awaiting admission elsewhere), musculoskeletal and nervous system diseases and mental and behavioural disorders (Table 3.19).
Figure 3.4:	Selected principal diagnoses by post-hospital destination
Horizontal bar chart showing post-hospital destination on y-axis and hospital separations (%) on x-axis. Key shows ‘diseases of the circulatory system (100-199)’, ‘neoplasms (tumours and cancers) (C00-D48)’, ‘diseases of the digestive system (K00-K93)’, ‘diseases of the respiratory system (J00-J99)’, ‘factors influencing health status and contact with health services (excluding Z75.1)’, ‘injury, poisoning and other consequences of external causes (S00-T98)’ and ‘awaiting admission elsewhere (Z75.1)’.
Note: The selected principal diagnoses accounted for at least 10% of separations for at least one post-hospital destination. Note that 
hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM 
chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Source: Table 3.16.

As noted previously, where multiple complex health conditions were present, it may have been difficult to identify one single condition that caused admission to hospital. Overall, 
16% of hospital episodes of one or more nights in hospital had only one diagnosis recorded and 7% had 10 or more (Table 3.22). Nearly half (46%) reported two to four diagnoses. The likelihood of discharge to RAC increased with the number of diagnoses recorded for the hospital episode: around 4% of hospital episodes with only a principal diagnosis reported (excluding those ending in death) resulted in a transition to RAC compared with around 20% of those with 10 or more reported diagnoses (Table 3.20).
For people moving from hospital to RAC, as the number of reported diagnoses increased the hospital episode was increasingly less likely to be for a person who was already a permanent aged care resident (Table 3.20). Around three-quarters of episodes with fewer than 5 recorded diagnoses were for people returning to permanent care compared with only 43% of episodes with 10 or more reported diagnoses. In general, the likelihood of being admitted into permanent rather than respite care increased with the number of recorded diagnoses. People admitted into RAC with 10 or more diagnoses reported for their transition hospital episode were nearly five times as likely to be admitted into permanent rather than respite care 
(Table 3.21). For those with five to nine reported diagnoses the ratio of permanent to respite admissions was 2.8 to 1.
The average number of diagnoses varied considerably with post-hospital destination 
(Figure 3.5). People who returned to the community or to permanent RAC were more likely to have only one diagnosis reported (18% and 9%, respectively) than others, with episodes ending with the death of the patient least likely to have only one recorded diagnosis (2%). Almost one quarter of episodes ending with the patient moving to permanent RAC or dying had 10 or more diagnoses recorded (24% and 25%, respectively); 13% of episodes for people moving into respite care had 10 or more reported diagnoses compared with 9% for people returning to permanent care and 5% for people going back to the community. The relationship between number of diagnoses and transition into permanent RAC is likely to be inter-related with the tendency to long hospital stays of this group: the longer a person with multiple conditions was in hospital the more likely it is that those conditions were recorded as additional diagnoses. 
Figure 3.5:	Reported co-morbidity by post-hospital destination
Two vertical bar charts showing hospital separations (%) on y-axes and ‘with one diagnosis’ and ‘with ten or more diagnoses’ on x-axes. Key shows ‘to community/other’, ‘returning to RAC’, ‘to respite RAC’, ‘to permanent RAC’ and ‘died in hospital’.
Source: Table 3.22.

Table 3.14:	Summary of movements from hospital into RAC for people aged 65+, by principal diagnosis, Australia, 2001–02 (in order of decreasing prevalence)
Principal diagnosis 
(ICD-10-AM Ed. 2 chapter )(a)	Returning to permanent RAC	To perm-anent RAC	To respite RAC	Total	Un-adjusted number	As per cent of all live hospital separations: estimated range	
	Row per cent		Est’d min %	Est’d max %	
Diseases of the circulatory system 
(I00–I99)	69.3	22.1	8.6	100.0	11,010	6.4	7.1	
Injury, poisoning and other consequences of external causes (S00–T98)	71.7	18.4	9.9	100.0	8,799	13.6	15.2	
Factors influencing health status and contact with health services (excluding Z75.1)	40.0	40.9	19.0	100.0	8,115	11.5	12.8	
Diseases of the respiratory system 
(J00–J99)	79.6	13.1	7.2	100.0	8,043	10.0	11.2	
Diseases of the digestive system 
(K00–K93)	86.7	7.9	5.5	100.0	5,304	5.9	6.6	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	69.8	20.6	9.6	100.0	5,209	7.6	8.4	
Awaiting admission elsewhere (Z75.1)	3.9	86.0	10.1	100.0	4,938	70.3	78.1	
Neoplasms (tumours and cancers) 
(C00–D48)	67.0	23.4	9.7	100.0	4,101	4.6	5.1	
Mental and behavioural disorders 
(F00–F99)	39.6	45.6	14.8	100.0	3,965	21.2	23.5	
Diseases of the genitourinary system (N00–N99)	78.1	15.7	6.3	100.0	3,754	7.0	7.8	
Diseases of the nervous system 
(G00–G99)	49.4	38.5	12.1	100.0	2,851	11.4	12.6	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	61.0	21.6	17.4	100.0	2,519	3.7	4.2	
Endocrine, nutritional and metabolic diseases (E00–E89)	74.7	17.1	8.2	100.0	2,289	9.8	10.9	
Diseases of the skin and subcutaneous tissue (L00–L99)	79.2	13.6	7.2	100.0	2,073	12.3	13.7	
Blood, blood-forming organs and immunological disorders (D50–D89)	89.1	6.6	4.3	100.0	1,234	9.9	11.0	
Infectious and parasitic diseases 
(A00–B99)	80.9	11.9	7.2	100.0	1,009	10.3	11.4	
Diseases of the eye and adnexa 
(H00–H59)	91.6	3.9	4.5	100.0	690	3.4	3.8	
Other/unknown	82.1	14.3	3.6	100.0	196	9.0	10.0	
Diseases of the ear and mastoid process (H60–H95)	70.3	>17.2	<12.5	100.0	64	1.8	2.0	
Congenital malformations (Q00–Q99)	75.0	<25.0	<25.0	100.0	16	2.9	3.2	
All	63.4	26.4	10.2	100.0	. .	8.5	9.4	
Total separations (number)	48,320	20,117	7,742	. .	76,179	      896,796	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters. Note that hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission.
Table 3.15:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by principal diagnosis, Australia, 2001–02 (unadjusted, in order of decreasing prevalence)
Principal diagnosis 
(ICD-10-AM Ed. 2 chapter )(a)	To permanent RAC	To respite
 RAC	Total	Permanent : respite admissions	
	Number (unadjusted hospital separations)	Ratio	
Factors influencing health status and contact with health services (excluding Z75.1)	3,323	1,543	4,866	2.2	:	1	
Awaiting admission elsewhere (Z75.1)	4,247	500	4,747	8.5	:	1	
Diseases of the circulatory system (I00–I99)	2,431	950	3,381	2.6	:	1	
Injury, poisoning and other consequences of external causes (S00–T98)	1,623	871	2,494	1.9	:	1	
Mental and behavioural disorders (F00–F99)	1,808	585	2,393	3.1	:	1	
Diseases of the respiratory system (J00–J99)	1,057	583	1,640	1.8	:	1	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	1,073	498	1,571	2.2	:	1	
Diseases of the nervous system (G00–G99)	1,099	345	1,444	3.2	:	1	
Neoplasms (tumours and cancers) (C00–D48)	958	397	1,355	2.4	:	1	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	545	438	983	1.2	:	1	
Diseases of the genitourinary system (N00–N99)	588	236	824	2.5	:	1	
Diseases of the digestive system (K00–K93)	417	290	707	1.4	:	1	
Endocrine, nutritional and metabolic diseases (E00–E89)	392	187	579	2.1	:	1	
Diseases of the skin and subcutaneous tissue (L00–L99)	282	149	431	1.9	:	1	
Infectious and parasitic diseases (A00–B99)	120	73	193	1.6	:	1	
Blood, blood-forming organs and immunological disorders (D50–D89)	82	53	135	1.5	:	1	
Diseases of the eye and adnexa (H00–H59)	27	31	58	0.9	:	1	
Other/unknown	28	7	35	4.0	:	1	
Diseases of the ear and mastoid process (H60–H95)	>10	<9	19	n.p.	:	1	
Congenital malformations (Q00–Q99)	<5	—	<5	. .	:	1	
All	20,117	7,742	27,859	2.6	:	1	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters. Note that hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
Table 3.16:	Hospital separations for people aged 65+, by principal diagnosis and movement type, Australia, 2001–02 (column per cent) (unadjusted, in order of decreasing prevalence)
Principal diagnosis 
(ICD-10-AM Ed. 2 chapter )(a)	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/
other	Died in hospital	All	N	
	Column per cent		
Diseases of the circulatory system (I00–I99)	15.8	12.1	12.3	19.6	25.4	19.5	185,315	
Neoplasms (tumours and cancers) (C00–D48)	5.7	4.8	5.1	10.4	28.6	11.0	104,410	
Diseases of the digestive system (K00–K93)	9.5	2.1	3.7	10.3	6.2	9.8	92,849	
Diseases of the respiratory system (J00–J99)	13.3	5.3	7.5	8.8	14.3	9.2	87,452	
Factors influencing health status and contact with health services (excluding Z75.1)	6.7	16.5	19.9	7.6	3.0	7.6	72,178	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	7.5	5.3	6.4	7.7	2.2	7.4	69,762	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	3.2	2.7	5.7	7.9	1.1	7.2	67,987	
Injury, poisoning and other consequences of external causes (S00–T98)	13.0	8.1	11.3	6.8	5.1	7.1	67,170	
Diseases of the genitourinary system (N00–N99)	6.1	2.9	3.0	6.1	3.4	5.8	55,423	
Diseases of the nervous system (G00–G99)	2.9	5.5	4.5	2.7	1.2	2.7	25,712	
Endocrine, nutritional and metabolic diseases (E00–E89)	3.5	1.9	2.4	2.6	2.1	2.6	24,425	
Diseases of the eye and adnexa (H00–H59)	1.3	0.1	0.4	2.4	0.0	2.2	20,431	
Mental and behavioural disorders (F00–F99)	3.3	9.0	7.6	1.8	0.9	2.0	19,221	
Diseases of the skin and subcutaneous tissue (L00–L99)	3.4	1.4	1.9	1.8	0.8	1.8	17,215	
Blood, blood-forming organs and immunological disorders (D50–D89)	2.3	0.4	0.7	1.4	0.5	1.4	12,803	
Infectious and parasitic diseases (A00–B99)	1.7	0.6	0.9	1.1	3.3	1.2	11,504	
Awaiting admission elsewhere (Z75.1)	0.4	21.1	6.5	0.3	1.6	0.8	7,860	
Diseases of the ear and mastoid process (H60–H95)	0.1	0.1	0.1	0.4	—	0.4	3,646	
Other/unknown	0.3	0.1	0.1	0.2	0.1	0.2	2,239	
Congenital malformations (Q00–Q99)	—	—	—	0.1	—	0.1	559	
Total	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	48,320	20,117	7,742	820,617	51,365	. .	948,161	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters. Note that hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	State/territory tables are in Appendix A.

Table 3.17:	Hospital separations for people aged 65+: mean length of stay, by principal diagnosis and movement type, Australia, 2001–02 (days) (unadjusted, in order of decreasing prevalence)
Principal diagnosis 
(ICD-10-AM Ed. 2 chapter )(a)	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/
other	Died in hospital	All	N	
	Mean (days)		
Diseases of the circulatory system (I00–I99)	7.5	36.1	17.5	6.1	10.8	6.9	185,315	
Neoplasms (tumours and cancers) 
(C00–D48)	7.0	30.6	19.3	6.8	15.0	8.2	104,410	
Diseases of the digestive system (K00–K93)	6.3	27.9	12.6	4.9	11.3	5.3	92,849	
Diseases of the respiratory system (J00–J99)	8.2	28.1	14.9	7.4	11.7	8.1	87,452	
Factors influencing health status and contact with health services (excluding Z75.1)	16.2	44.1	25.0	15.5	78.4	18.4	72,178	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	5.7	28.3	13.5	4.1	13.1	4.7	69,762	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	9.4	35.2	16.8	7.0	17.7	7.4	67,987	
Injury, poisoning and other consequences of external causes (S00–T98)	8.5	33.2	17.8	7.8	13.4	8.8	67,170	
Diseases of the genitourinary system 
(N00–N99)	6.8	26.8	15.3	4.9	12.0	5.5	55,423	
Diseases of the nervous system (G00–G99)	8.5	49.6	17.6	5.7	32.4	8.6	25,712	
Endocrine, nutritional and metabolic diseases (E00–E89)	8.0	27.5	19.3	7.2	15.4	8.0	24,425	
Diseases of the eye and adnexa (H00–H59)	2.3	64.3	4.9	1.7	25.8	1.8	20,431	
Mental and behavioural disorders (F00–F99)	18.8	62.3	26.6	19.5	111.5	26.0	19,221	
Diseases of the skin and subcutaneous tissue (L00–L99)	10.2	31.1	17.9	9.3	18.0	10.0	17,215	
Blood, blood-forming organs and immunological disorders (D50–D89)	4.7	26.0	14.6	4.8	13.2	5.1	12,803	
Infectious and parasitic diseases (A00–B99)	9.2	23.7	19.3	8.1	10.4	8.7	11,504	
Awaiting admission elsewhere (Z75.1)	10.0	35.3	24.1	38.0	96.4	41.1	7,860	
Diseases of the ear and mastoid process (H60–H95)	4.8	16.8	30.8	3.5	n.p.	3.6	3,646	
Other/unknown	4.3	25.2	16.0	4.4	13.7	4.7	2,239	
Congenital malformations (Q00–Q99)	5.9	n.p.	—	4.8	11.9	5.3	559	
All	8.4	38.2	19.5	7.1	17.2	8.5	. .	
Total separations (number)	48,320	20,117	7,742	820,617	51,365	. . 	948,161	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters. Note that hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.

Table 3.18:	Hospital separations for people aged 65+: median length of stay, by principal diagnosis and movement type, Australia, 2001–02 (days) (unadjusted, in order of decreasing prevalence)
Principal diagnosis 
(ICD-10-AM Ed. 2 chapter )(a)	Returning to permanent RAC	To permanent RAC	To
 respite RAC	To community/
other	Died in hospital	All	N	
	Median (days)		
Diseases of the circulatory system (I00–I99)	6	26	13	4	5	4	185,315	
Neoplasms (tumours and cancers) 
(C00–D48)	4	22	14	4	9	5	104,410	
Diseases of the digestive system (K00–K93)	4	20	9	3	6	3	92,849	
Diseases of the respiratory system (J00–J99)	6	20	11	6	6	6	87,452	
Factors influencing health status and contact with health services (excluding Z75.1)	14	30	20	11	17	12	72,178	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	4	20	9	2	7	2	69,762	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	7	23	12	6	11	6	67,987	
Injury, poisoning and other consequences of external causes (S00–T98)	6	25	14	5	8	5	67,170	
Diseases of the genitourinary system 
(N00–N99)	5	20	11.5	3	7	4	55,423	
Diseases of the nervous system (G00–G99)	5	25	11	2	10	3	25,712	
Endocrine, nutritional and metabolic diseases (E00–E89)	6	21	14	4	9	5	24,425	
Diseases of the eye and adnexa (H00–H59)	1	3	1	1	12	1	20,431	
Mental and behavioural disorders (F00–F99)	13	26	17	10	17	12	19,221	
Diseases of the skin and subcutaneous tissue (L00–L99)	7	23.5	14	6	11	7	17,215	
Blood, blood-forming organs and immunological disorders (D50–D89)	3	18	13	3	8	3	12,803	
Infectious and parasitic diseases (A00–B99)	7	18.5	15	6	6	6	11,504	
Awaiting admission elsewhere (Z75.1)	7	20	14	18	23	19	7,860	
Diseases of the ear and mastoid process (H60–H95)	4	14	n.p.	2	n.p.	2	3,646	
Other/unknown	3	17	n.p.	3	10	3	2,239	
Congenital malformations (Q00–Q99)	3	n.p.	—	3	n.p.	3	559	
All	6	24	14	4	7	5	. .	
Total separations (number)	48,320	20,117	7,742	820,617	51,365	. . 	948,161	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters. Note that hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	Table excludes same-day hospital episodes, statistical discharges and transfers to other hospitals.
Table 3.19:	Hospital separations for people aged 65+: 90th percentile of length of stay, by principal diagnosis and movement type, Australia, 2001–02 (days) (unadjusted, in order of decreasing prevalence)
Principal diagnosis 
(ICD-10-AM Ed. 2 chapter )(a)	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/other	Died in hospital	All	N	
	90th percentile (days)		
Diseases of the circulatory system (I00–I99)	15	64	36	13	23	14	185,315	
Neoplasms (tumours and cancers) 
(C00–D48)	17	66	40	15	34	18	104,410	
Diseases of the digestive system (K00–K93)	13	59	28	11	27	11	92,849	
Diseases of the respiratory system (J00–J99)	16	55	30	14	23	16	87,452	
Factors influencing health status and contact with health services (excluding Z75.1)	32	81	48	32	101	36	72,178	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	13	58	30	9	27	10	69,762	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	21	71	34	14	42	14	67,987	
Injury, poisoning and other consequences of external causes (S00–T98)	18	64	35	18	31	20	67,170	
Diseases of the genitourinary system 
(N00–N99)	14	55	31	10	26	11	55,423	
Diseases of the nervous system (G00–G99)	20	100	36	13	42	17	25,712	
Endocrine, nutritional and metabolic diseases (E00–E89)	17	59	36	16	36	18	24,425	
Diseases of the eye and adnexa (H00–H59)	5	n.p.	n.p.	2	n.p.	2	20,431	
Mental and behavioural disorders (F00–F99)	42	107	49	41	157	47	19,221	
Diseases of the skin and subcutaneous tissue (L00–L99)	21	65	35	19	37	21	17,215	
Blood, blood-forming organs and immunological disorders (D50–D89)	11	n.p.	n.p.	11	32	12	12,803	
Infectious and parasitic diseases (A00–B99)	18	50.5	n.p.	17	26	19	11,504	
Awaiting admission elsewhere (Z75.1)	21	76	50	75	198	77	7,860	
Diseases of the ear and mastoid process (H60–H95)	n.p.	n.p.	n.p.	8	n.p.	8	3,646	
Other/unknown	9	n.p.	n.p.	9	27	10	2,239	
Congenital malformations (Q00–Q99)	n.p.	n.p.	—	11	n.p.	11	559	
All	19	73	40	15	31	18	. .	
Total separations (number)	48,320	20,117	7,742	820,617	51,365	. . 	948,161	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters. Note that hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter (Ed.2) ‘Factors influencing health status and contact with health services’ and presented separately.
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
Table 3.20:	Summary of movements from hospital into RAC for people aged 65+, by movement type and number of diagnoses, Australia, 2001–02 
Number of diagnoses	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
	Row per cent		Est’d min %	Est’d max %	
One diagnosis	76.2	16.0	7.8	100.0	5,609	3.7	4.1	
2–4 diagnoses	73.1	17.0	9.9	100.0	27,850	6.6	7.3	
5–9 diagnoses	59.5	29.8	10.8	100.0	32,558	12.1	13.5	
10 or more diagnoses	42.5	47.2	10.3	100.0	10,115	19.1	21.2	
All	63.4	26.4	10.2	100.0	. .	8.5	9.5	
Total separations (number)	48,294	20,099	7,739	. .	76,132	                895,923	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	The number of diagnoses recorded relates to those recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). 
3.	Age is as at time of hospital admission.
4.	47 records were excluded due to missing diagnosis codes.

Table 3.21:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by movement type and number of diagnoses, Australia, 2001–02 (unadjusted hospital separations)
Number of diagnoses	To permanent RAC	To respite
 RAC	Total	Permanent : respite admissions	
	Number (unadjusted hospital separations)	Ratio	
One diagnosis	                  900 	                  436 	               3,661 	2.1	:	1	
2–4 diagnoses	               4,736 	               2,761 	               8,240 	1.7	:	1	
5–9 diagnoses	               9,687 	               3,504 	             10,725 	2.8	:	1	
10 or more diagnoses	               4,776 	               1,038 	             12,515 	4.6	:	1	
All	             20,099 	               7,739 	27,838  	2.6	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of 
transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	The number of diagnoses recorded relates to those recorded during the last hospital episode before discharge 
from the hospital system (see Box 1.1). 
3.	Age is as at time of hospital admission.
4.	47 records were excluded due to missing diagnosis codes.

Table 3.22:	Hospital separations for people aged 65+, by movement type, age and number of diagnoses, Australia, 2001–02 (unadjusted)
Age/number of diagnoses	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/
other	Died in hospital	All	N	
	Column per cent		
One diagnosis	8.8	4.5	5.6	17.7	2.4	16.0	151,905	
2–4 diagnoses	42.1	23.6	35.7	48.3	24.8	46.1	436,889	
5–9 diagnoses	40.1	48.2	45.3	28.7	47.5	30.9	292,498	
10 or more diagnoses	8.9	23.8	13.4	5.2	25.3	7.0	65,952	
Total 	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	48,294	20,099	7,739	819,791	51,321	. .	947,244	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	The number of diagnoses recorded relates to those recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). 
3.	Age is as at time of hospital admission.
4.	917 records were excluded due to missing diagnosis codes.

3.5	Regional profile
The type of care received in hospital varied with the remoteness of the patient’s usual residence and movement type (Table 3.23). Across all movement types except death, the percentage of acute care episodes increased with remoteness. For example, one-half of hospital episodes for people from major cities who moved into permanent RAC were for acute care, compared with 58% of episodes for those from remote and very remote areas. Rehabilitative hospital episodes were far more common for people who usually lived in major cities than in other regions for all movement types. For example, 17% of hospital episodes for people from a major city who moved into respite RAC were for rehabilitation, compared with 6–7% for people from inner and outer regional areas and 3% for those from remote and very remote areas (Table 3.23). Maintenance episodes were more frequent amongst people who moved from regions outside of major cities into permanent RAC (26%–31% for regional and remote areas versus 19% for major cities). 
The time spent in hospital varied according to the post-hospital destination and the remoteness of the person’s usual residence (Table 3.24). Generally, hospital episodes for people moving either temporarily into or returning to RAC were shorter for people from more remote areas. For example, hospital episodes for people returning to RAC in major cities lasted a median length of 6 days (mean of 8.9 days), compared with a median of 4 days (mean of 5.9 days) for those from remote areas and a median of 3 days (mean of 6.7 days) for those from very remote areas. Hospitals episodes for people moving into respite RAC from hospital were shorter for people from more remote areas, with a median of 14 days for people who usually lived in major cities and inner regional areas, compared with medians of 10 and 5.5 days for people from remote and very remote areas, respectively. Mean lengths of stay followed a similar pattern.
The association of hospital episode length and remoteness for people moving into permanent RAC from hospital was more complex. Median episode length for these hospital episodes decreased with increasing remoteness of usual residence, with a median of 24 days in major cities and 20 days for people from very remote areas. In contrast, for people who moved into permanent RAC the mean length of hospital episode generally increased with remoteness, with a mean of 35.8 days for people from major cities and 54.3 and 46.7 days for those who usually lived in remote and very remote areas, respectively. This indicates that among people moving into permanent RAC from hospital, some people from remote areas stayed in hospital a great deal longer than those who came from major cities. In particular, at least 10% of episodes for people from outer regional areas who were discharged into permanent RAC lasted 94 days or more compared with 69 days for people from major cities. For people from remote areas the 90th percentile for length of stay was 104 days. These differences could either reflect a greater need to ensure medical stability before discharging people from more remote regions (due to greater difficulty in accessing health services quickly) or could indicate difficulties in accessing permanent RAC suited to the person’s needs in more remote areas.
While the median lengths of hospital episodes for people who died in hospital were similar across all regions (7–8 days), the mean and 90th percentile increased with remoteness of usual residence. Episodes for people from major cities who died in hospital had a mean of 13.6 days compared with 50.1 for people from very remote regions. Similarly, at least 10% of people from major cities and inner regional areas who died in hospital spent more than 30 days in hospital, compared with 76 days for people from very remote areas. 
Table 3.23:	Hospital separations for people aged 65+, by movement type, hospital care type and remoteness of person prior to admission into hospital, 2001–02 (unadjusted)
Movement type/hospital care type	Major cities	Inner regional	Outer regional	Remote and very remote 	Australia	N	
Return to permanent RAC	Column per cent	
Acute	91.6	94.8	96.6	97.9	92.8	44,679	
Rehabilitation	5.4	3.0	2.2	0.9	4.5	2,180	
Palliative	0.4	0.4	0.2	<0.9	0.4	171	
GEM	1.3	1.0	0.4	—	1.1	551	
Psychogeriatric	0.7	0.1	<0.1	—	0.5	228	
Maintenance	0.6	0.7	0.4	<0.9	0.6	283	
Other	0.1	0.1	<0.1	<0.9	0.1	42	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	32,526	10,386	4,686	536	. .	48,134	
To permanent RAC							
Acute	50.0	53.1	54.1	57.9	51.0	10,226	
Rehabilitation	12.4	6.3	5.4	7.9	10.5	2,104	
Palliative	1.9	1.9	<1.8	<4.0	1.9	373	
GEM	9.9	5.5	2.2	—	8.3	1,664	
Psychogeriatric	1.1	0.6	<0.3	—	0.9	186	
Maintenance	19.1	26.1	30.6	30.7	21.6	4,332	
Other	5.6	6.4	6.1	<4.0	5.8	1,158	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	14,073	4,197	1,633	140	. .	20,043	
To respite RAC							
Acute	71.6	75.4	75.3	83.2	73.4	5,662	
Rehabilitation	17.1	7.0	6.0	3.4	12.7	978	
Palliative	0.8	0.9	1.5	<3.4	1.0	74	
GEM	2.0	2.3	1.2	—	2.0	151	
Psychogeriatric	1.0	0.2	<0.5	<3.4	0.7	52	
Maintenance	7.1	11.7	14.9	10.7	9.4	726	
Other	0.4	2.4	<1.0	<3.4	1.0	76	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	4,510	2,018	1,042	149	. .	7,719	
						(continued)	
Table 3.23 (continued): Hospital separations for people aged 65+, by movement type, hospital care type and remoteness of person prior to admission into hospital, 2001–02 (unadjusted)
Movement type/hospital care type	Major cities	Inner regional	Outer regional	Remote and very remote 	Australia	N	
To community/other	Column per cent	
Acute	91.8	94.8	95.7	95.1	93.1	755,596	
Rehabilitation	5.8	3.0	1.9	1.3	4.6	37,189	
Palliative	0.5	0.6	0.5	0.4	0.5	4,367	
GEM	0.9	0.7	0.3	0.1	0.7	6,008	
Psychogeriatric	0.2	—	—	—	0.1	911	
Maintenance	0.4	0.8	1.4	2.9	0.7	5,344	
Other	0.4	0.1	0.1	0.2	0.3	2,336	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	501,819	198,025	95,390	16,517	. .	811,751	
Died in hospital							
Acute	77.6	77.7	77.5	74.7	77.5	39,744	
Rehabilitation	1.4	0.9	0.8	<1.1	1.2	607	
Palliative	17.8	16.1	14.0	14.1	16.9	8,666	
GEM	1.4	1.1	0.3	—	1.2	623	
Psychogeriatric	0.1	—	0.1	—	0.1	56	
Maintenance	1.3	3.3	6.7	10.2	2.5	1,301	
Other	0.3	0.9	0.7	<0.6	0.5	253	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	32,927	11,681	5,758	884	. .	51,250	
All 							
Acute	89.9	93.0	93.9	93.8	91.2	855,907	
Rehabilitation	5.8	3.0	2.0	1.3	4.6	43,058	
Palliative	1.5	1.4	1.2	1.1	1.5	13,651	
GEM	1.2	0.8	0.3	0.1	1.0	8,997	
Psychogeriatric	0.2	0.1	0.1	—	0.2	1,433	
Maintenance	0.9	1.5	2.2	3.5	1.3	11,986	
Other	0.5	0.3	0.2	0.2	0.4	3,865	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	585,855	226,307	108,509	18,226	. .	938,897	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the ABS (ABS 2001b). 
4.	Newborn care types, organ procurement and hospital boarders were excluded from the table (1 case).
5.	6,107 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
6.	3,667 records were excluded due to missing valid postcodes for remoteness coding. One further record was excluded due to missing hospital care type.
Table 3.24:	Hospital separations for people aged 65+: mean, median and 90th percentile of length of stay, by movement type and remoteness of person prior to admission into hospital, 2001–02 (unadjusted)
Movement type	Major cities	Inner regional	Outer regional	Remote 	Very remote	Australia	N	
	Mean (days)		
Return to permanent RAC 	8.9	7.6	7.1	5.9	6.7	8.4	       48,302 	
To permanent RAC	35.8	41.0	51.1	54.3	46.7	38.2	       20,096 	
To respite RAC	19.7	19.8	18.7	14.8	9.8	19.5	         7,728 	
To community/other	7.4	6.7	6.9	6.2	7.1	7.1	     817,114 	
Died in hospital	13.6	18.4	30.5	49.2	50.1	17.3	       51,253 	
All	8.6	8.1	8.9	8.8	9.3	8.5	. .	
	Median (days)		
Return to permanent RAC	6	5	5	4	3	6	       48,302 	
To permanent RAC	24	23	23	20	21	24	       20,096 	
To respite RAC	14	14	11	10	5.5	14	         7,728 	
To community/other	4	4	4	4	4	4	     817,114 	
Died in hospital	8	7	7	8	7	7	       51,253 	
All	5	4	4	4	4	5	. .	
	90th percentile (days)		
Return to permanent RAC	20	17	16	13	12	19	       48,302 	
To permanent RAC	69	79	97	104	n.p.	73	       20,096 	
To respite RAC	41	40	37	34	n.p.	40	         7,728 	
To community/other	16	14	14	13	14	15	     817,114 	
Died in hospital	30	30	38	43	76	31	       51,253 	
All	19	16	16	14	15	18	. .	
Total separations (number)	       585,855 	       230,808 	      109,496 	        13,420 	     4,914 	. .	944,493	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the ABS (ABS 2001b).
4.	3,667 records were missing valid postcodes for remoteness coding. 

4	Moving into residential aged care
As stated earlier, the majority (72%) of admissions into RAC from hospital were for permanent care. However, the reverse was true for admissions from the community, with 36% of such admissions being into permanent care (Figure 4.1, Table 4.2). Relatively few people transferred into respite RAC, with transfers into permanent care being 14 times more common.
Figure 4.1: Profile of admissions into RAC
Vertical bar chart showing admissions (%) on y-axis and origin on x-axis. Key shows ‘into respite care’ and ‘into permanent care’.
Source: Table 4.2.
4.1	Characteristics of people admitted into residential aged care
Overall, almost 60% of non-transfer admissions into permanent care were from hospital, as were 20% of non-transfer admissions into respite care (Table 4.1). Women admitted into permanent care were less likely than men to have been admitted from hospital (54% for women versus 62% for men). However, for admissions into respite RAC similar proportions of men and women came as discharges from hospital. There was some evidence that older people were less likely to be admitted into permanent care from hospital than younger people, but the differences were small (Table 4.1). People admitted into permanent residential care—whether from hospital, from the community or as a transfer within RAC—had a slightly older age profile than those admitted for respite care (Table 4.2, Figure 4.2). For example, in 2001–02, 70% of the permanent admissions for people coming from hospital were for people aged 80 and over (45% aged 85+) compared with 67% of respite admissions (40% aged 85+). As expected, for all movement groups less than half the transitions were for men, and the women were, on average, older than the men. 
The differences in age profiles across the transition groups were not the same for men and women (Table 4.2). Men moving from hospital into permanent RAC tended to be younger than men admitted from the community (48% aged less than 80 years compared with 44%), while there was little difference for women (75% versus 76%). On the other hand, among men moving into respite care, those coming from hospital had a slightly older age profile than those coming from the community (59% aged 80+ versus 56%, p<0.01). The reverse was true for women moving into respite care, with those entering from hospital tending to be slightly younger than those coming from the community (71% aged 80+ and 43% aged 85+ compared with 72% and 47%).
Figure 4.2:	Age and sex profile of admissions into RAC
Two vertical bar charts showing admissions (%) on y-axes and ‘%80+’ and ‘%male’ on x-axes. Key shows ‘from hospital’, ‘transfer from RAC’ and ‘from community’. 
Source: Table 4.2.
Table 4.1:	Origin of non-transfer admissions into RAC for people aged 65+, admission type by age, sex and location of ACAT assessment, Australia, 2001–02 (adjusted)
	Into permanent RAC		Into respite RAC	
Movement type/sex	From hospital	From the community	Total	Non-transfer adm-issions		From hospital	From the community	Total	Non-transfer adm-issions	
Age	Per cent (adjusted)	Number		Per cent (adjusted)	Number	
65–69	60	40	100	1,337		17	83	100	1,988	
70–74	59	41	100	3,183		20	80	100	4,039	
75–79	59	41	100	6,413		22	78	100	7,597	
Subtotal 65–79	59	41	100	10,933		21	79	100	13,624	
80–84	56	44	100	9,925		22	78	100	10,527	
85–89	55	45	100	10,348		21	79	100	10,296	
90–94	56	44	100	5,674		21	79	100	5,026	
95+	59	41	100	1,506		19	81	100	1,165	
Subtotal 80+	56	44	100	17,528		21	79	100	16,487	
										
Sex										
Men	62	38	100	13,260		20	80	100	14,980	
Women	54	46	100	25,126		22	78	100	25,658	
										
Location of ACAT assessment										
Aged care facility	44	56	100	2,651		18	82	100	1,953	
At home	24	76	100	13,730		9	91	100	28,145	
Hospital	83	17	100	20,343		63	37	100	8,587	
Other	30	70	100	1,639		12	88	100	1,943	
Missing/
Unknown	57	43	100	23		—	100	100	10	
										
All admissions 
(per cent adjusted)	57	43	100	. .		21	79	100	. .	
Total admissions (adjusted number)	21,800	16,600	. .	38,386		8,600	32,000	. .	40,638	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of adjusted numbers.
2.	Age is as at time of RAC admission.
3.	Per cents are based on adjusted numbers and so have been rounded to the nearest percentage point to reflect accuracy of the adjusted figures (see Box 2.1).
4.	Number of non-transfer admissions is an observed number and does not require adjustment.

Table 4.2:	RAC admissions for people aged 65+, by movement type, age and sex, Australia, 2001–02 (unadjusted)
	Age at RAC admission/transfer			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.2	11.5	21.1	26.5	22.5	10.6	2.4	100.0	7,636	
From community into permanent RAC	5.2	11.1	18.0	25.2	25.4	12.6	2.6	100.0	5,624	
Transfer into permanent RAC	5.4	10.7	19.4	25.0	23.8	12.8	2.9	100.0	5,961	
Subtotal 	5.3	11.2	20.0	25.7	23.4	11.8	2.6	100.0	19,221	
Respite admissions										
From hospital to respite RAC 	5.9	12.2	22.8	26.4	20.7	10.1	1.9	100.0	2,720	
From community into respite RAC	7.7	13.5	22.6	25.5	19.7	9.2	1.9	100.0	12,260	
Transfer into respite RAC	7.8	10.4	22.6	24.6	24.0	9.0	1.4	100.0	499	
Subtotal 	7.7	11.4	22.6	24.9	22.6	9.1	1.6	100.0	15,479	
All	6.2	12.1	21.0	25.6	22.1	10.7	2.3	100.0	. .	
Total admissions (number)	2,153	4,186	7,285	8,890	7,665	3,730	791	. .	34,700	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	2.7	6.9	15.0	25.1	28.3	16.9	5.1	100.0	12,489	
From community into permanent RAC	2.4	6.4	15.2	26.5	29.0	16.1	4.3	100.0	12,637	
Transfer into permanent RAC	2.0	6.2	14.2	24.5	29.4	18.1	5.7	100.0	 13,547 	
Subtotal 	2.4	6.5	14.8	25.4	28.9	17.1	5.0	100.0	38,673 	
Respite admissions										
From hospital to respite RAC 	2.9	7.9	17.8	28.1	27.3	13.0	3.0	100.0	5,024	
From community into respite RAC	3.6	8.0	16.0	25.6	28.8	14.4	3.6	100.0	20,634	
Transfer into respite RAC	3.0	7.4	16.9	29.1	27.9	13.1	2.6	100.0	 876 	
Subtotal 	3.4	8.0	16.4	26.2	28.5	14.1	3.4	100.0	26,534 	
All	2.8	7.1	15.4	25.7	28.7	15.9	4.4	100.0	. .	
Total admissions (number)	1,825	4,628	10,062	16,750	18,738	10,349	2,855	. .	65,207	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.7	8.7	17.3	25.6	26.1	14.6	4.1	100.0	20,125	
From community into permanent RAC	3.3	7.9	16.1	26.1	27.9	15.0	3.7	100.0	18,261	
Transfer into permanent RAC	3.0	7.6	15.8	24.7	27.7	16.5	4.8	100.0	 19,508 	
Subtotal 	3.3	8.0	16.4	25.5	27.2	15.4	4.2	100.0	57,894 	
Respite admissions										
From hospital to respite RAC 	4.0	9.4	19.5	27.5	25.0	12.0	2.6	100.0	7,744	
From community into respite RAC	5.1	10.1	18.5	25.5	25.4	12.5	2.9	100.0	32,894	
Transfer into respite RAC	4.7	8.5	19.0	27.5	26.5	11.6	2.2	100.0	 1,375 	
Subtotal 	4.9	9.9	18.7	26.0	25.4	12.3	2.8	100.0	42,013 	
All	4.0	8.8	17.4	25.7	26.4	14.1	3.6	100.0	. .	
Total admissions (number)	3,978	8,814	17,347	25,640	26,403	14,079	3,646	. .	99,907	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer.
3.	State/territory tables are in Appendix A.

4.2	Place of assessment 
Assessment by an Aged Care Assessment Team (ACAT) provides a single point of entry to a range of government-funded aged care services, including permanent and respite RAC (AIHW 2007a:chapter 3). An ACAT approval remains valid for 12 months. If a person’s care needs change to the extent that a different level or type of care is required, they may be reassessed within that period. Prior to 1 July 2004 residents needed an ACAT recommendation to move between low and high care, even within the same aged care home. After 1 July 2004 this requirement was removed for residents moving between low and high care within the same facility. People moving into RAC directly from hospital would have received an ACAT assessment either in hospital or before entering hospital. 
As expected, people assessed in hospital were much more likely than others to be admitted into RAC directly from hospital (Table 4.1). However, the effect was more marked for permanent than for respite admissions: for people assessed in hospital 83% of admissions into permanent care were from hospital compared with 63% of admissions into respite care. In contrast, for people assessed at home about one-quarter (24%) of permanent admissions and one tenth (9%) of respite admissions were from hospital.
As the above figures foreshadow, assessment was more likely to have taken place in hospital for people admitted to RAC from hospital than for others, with assessment in hospital being associated with 77% of admissions to permanent care from hospital compared with 26% for admissions into permanent care from the community (Table 4.3). Irrespective of their 
pre-admission sector, people admitted for respite care were less likely than those admitted for permanent care to have been assessed in hospital and more likely to have been assessed at home. For example, for 30% of respite admissions from hospital the associated assessment had been at home compared with 15% of permanent admissions from hospital. 
While the patterns for place of assessment were generally similar for men and women, there were some differences: women transferring into permanent RAC were more likely than men to have been assessed at a RAC facility and less likely to have been assessed in hospital or at home.

Table 4.3:	RAC entries for people aged 65+, by movement type, sex and location of most recent ACAT assessment prior to move, Australia, 2001–02 (unadjusted)
	Location of most recent ACAT assessment prior to move		
Sex movement type	Aged care facility	At home	Hospital	Other	Missing/
Unknown	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	4.1	15.5	78.0	2.3	—	100.0	7,636	
From community into permanent RAC	8.8	55.1	29.3	6.8	—	100.0	5,624	
Transfer into permanent RAC	23.7	28.2	41.6	4.3	2.3	100.0	5,961	
Subtotal 	11.6	31.0	52.4	4.2	0.7	100.0	    19,221 	
Respite admissions								
From hospital to respite RAC 	3.8	31.7	61.7	2.8	—	100.0	2,720	
From community into respite RAC	4.9	78.9	11.5	4.7	—	100.0	12,260	
Transfer into respite RAC	13.2	52.9	27.5	6.4	—	100.0	499	
Subtotal 	4.9	69.8	20.8	4.5	0.0	100.0	    15,479 	
All	8.6	48.3	38.3	4.3	0.4	100.0	. .	
Total admissions (number)	2,987	16,761	13,303	1,505	144	. .	34,700	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	6.2	14.8	76.7	2.2	0.1	100.0	12,489	
From community into permanent RAC	8.4	60.1	25.0	6.4	0.1	100.0	12,637	
Transfer into permanent RAC	30.0	26.4	36.1	4.1	3.4	100.0	13,547	
Subtotal 	15.3	33.7	45.6	4.2	1.2	100.0	    38,673 	
Respite admissions								
From hospital to respite RAC 	4.2	29.8	63.5	2.5	—	100.0	5,024	
From community into respite RAC	5.1	78.1	11.2	5.6	—	100.0	20,634	
Transfer into respite RAC	15.2	46.3	33.6	4.8	0.1	100.0	876	
Subtotal 	5.2	67.9	21.8	5.0	0.0	100.0	    26,534 	
All	11.2	47.6	35.9	4.5	0.7	100.0	. .	
Total admissions (number)	7,290	31,039	23,429	2,966	483	. .	65,207	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.4	15.1	77.2	2.2	0.1	100.0	20,125	
From community into permanent RAC	8.6	58.5	26.3	6.5	0.1	100.0	18,261	
Transfer into permanent RAC	28.1	26.9	37.8	4.2	3.0	100.0	19,508	
Subtotal 	14.0	32.8	47.9	4.2	1.1	100.0	    57,894 	
Respite admissions								
From hospital to respite RAC 	4.1	30.4	62.8	2.6	—	100.0	7,744	
From community into respite RAC	5.0	78.4	11.3	5.3	—	100.0	32,894	
Transfer into respite RAC	14.5	48.7	31.3	5.4	0.1	100.0	1,375	
Subtotal 	5.1	68.6	21.5	4.8	0.0	100.0	    42,013 	
All	10.3	47.8	36.8	4.5	0.6	100.0	. .	
Total admissions (number)	10,277	47,800	36,732	4,471	627	. .	99,907	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission.
4.3	Care needs 
People admitted to permanent RAC have their care needs assessed soon after entering the facility. In 2001–02, the tool used for this assessment was the Resident Classification Scale (RCS) (see Box 1.2). People with needs placing them in RCS categories 1 to 4 were classified as high-care residents and those meeting the criteria for RCS categories 5 to 8 were classified as low-care residents. People admitted for respite care were classified as either high- or 
low-care clients as part of their ACAT assessment.
The proportion of people with high-care needs on admission to RAC varied considerably with the type of transition, ranging from 34% for people entering respite care from the community to 83% for people admitted to permanent care from hospital (Figure 4.3). People admitted from the community tended to have lower care needs than both those transferring within RAC and those admitted from hospital. In general, within transition and age group, on average women had lower care needs than men. Within most transition groups, until around the 85–89 age group the percentage of entries related to people with high-care needs either decreased as age increased or was fairly stable; the percentage then increased with age among the older age groups (Table 4.4).

Figure 4.3:	Per cent of admissions to RAC for people with high-care needs, 2001–02
Vertical bar chart showing per cent in high care on y-axis and type of entry on x-axis.
Source: Table 4.4.
Table 4.4:	RAC entries for people aged 65+: care level on transition, by movement type, age and sex, Australia, 2001–02 (% high care) (unadjusted)
	Age at RAC admission/transfer		
Movement type/sex	65–69	70–74	75–79	80–84	85–89	90–94	95+	 All	N	
Men	Per cent at high care		
Permanent admissions			
From hospital to permanent RAC 	84.3	84.1	85.7	85.9	85.3	84.7	92.5	85.5	7,636	
From community into permanent RAC	55.0	56.0	51.4	46.7	42.2	41.3	56.3	47.4	5,624	
Transfer into permanent RAC	73.5	71.7	74.9	74.8	74.5	74.6	81.1	74.5	5,961	
Subtotal 	72.4	72.2	73.2	71.3	68.5	67.9	78.3	71.0	19,221	
Respite admissions										
From hospital to respite RAC 	45.3	49.2	48.3	47.0	51.3	51.8	64.7	49.2	2,720	
From community into respite RAC	47.7	46.0	45.2	38.1	35.1	32.8	40.5	40.5	12,260	
Transfer into respite RAC	53.8	50.0	60.2	60.2	57.5	44.4	57.1	56.5	499	
Subtotal 	47.6	46.7	46.3	40.4	38.9	36.8	45.3	42.5	15,479	
All	59.3	59.8	60.2	57.5	56.5	55.8	66.4	58.3	. .	
Total admissions (number)	2,153	4,186	7,285	8,890	7,665	3,730	791	. .	34,700	
Women										
Permanent admissions										
From hospital to permanent RAC 	81.3	81.6	80.1	80.1	78.7	83.8	88.2	80.9	12,489	
From community into permanent RAC	47.4	41.9	38.4	34.6	33.3	37.2	54.5	36.9	12,637	
Transfer into permanent RAC	69.7	70.7	67.5	67.4	70.4	76.5	85.2	71.2	13,547	
Subtotal 	66.6	65.1	61.8	60.2	60.9	66.7	77.7	63.1	38,673	
Respite admissions										
From hospital to respite RAC 	49.3	40.6	36.4	37.0	37.1	46.2	56.9	39.4	5,024	
From community into respite RAC	48.5	40.8	33.1	27.9	23.4	30.0	34.9	29.8	20,633	
Transfer into respite RAC	50.0	49.2	43.2	49.8	41.4	59.1	56.5	47.7	876	
Subtotal 	48.7	41.0	34.2	30.5	26.5	33.7	39.1	32.2	26,533	
All	57.6	54.1	49.9	47.9	47.0	54.8	65.4	50.5	. .	
Total admissions (number)	1,825	4,628	10,062	16,750	18,737	10,349	2,855	. .	65,206	
All										
Permanent admissions										
From hospital to permanent RAC 	82.9	82.8	82.7	82.4	80.9	84.1	89.2	82.6	20,125	
From community into permanent RAC	51.1	48.1	42.9	38.2	35.8	38.3	54.9	40.1	18,261	
Transfer into permanent RAC	71.8	71.1	70.3	69.7	71.5	76.0	84.4	72.2	19,508	
Subtotal 	69.7	68.4	66.4	63.9	63.1	67.0	77.8	65.7	57,894	
Respite admissions										
From hospital to respite RAC 	47.2	44.5	41.3	40.4	41.2	47.9	58.8	42.8	7,744	
From community into respite RAC	48.1	43.4	38.6	31.7	26.8	30.8	36.2	33.8	32,893	
Transfer into respite RAC	52.3	49.6	50.6	53.2	46.7	55.0	56.7	50.9	1,375	
Subtotal 	48.1	43.8	39.6	34.1	30.1	34.6	40.6	36.0	42,012	
All	58.5	56.8	54.2	51.3	49.8	55.1	65.6	53.2	. .	
Total admissions (number)	3,978	8,814	17,347	25,640	26,402	14,079	3,646	. .	99,906	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer. 
3.	1 record excluded due to missing RCS level.
4.4	Regional profile 
When people were admitted into residential care they did not always stay within their region of usual residence. In particular, people who lived outside major cities tended to move into RAC facilities in less remote locations than where they had previously resided, although moves in the other direction did occur. Fewer than 90% of admissions for people from outside a major city were into a RAC facility of the same region type as the person’s usual residence (Table 4.5). This percentage varied both with the person’s region and type of transition. For example, 87% of hospital to permanent care transitions for people from an inner regional area were into RAC facilities in a similar area; 10% involved moving into a facility in a major city and in 3% of cases the RAC facility was in an outer regional area. In comparison, for people living in remote and very remote areas admitted into respite care from the community 83% of admissions were into similarly remote RAC facilities, 11% were into facilities in an outer regional area and the remaining 6% involved moves into a major city or an inner regional area. A similar shift towards less remote regions was also evident for admissions into permanent RAC from the community. 
Table 4.5:	RAC entries for people aged 65+: remoteness of person prior to admission into RAC, by remoteness of RAC facility and movement type, 2001–02 (unadjusted)
	Remoteness of RAC facility		
Movement type/remoteness of usual residence prior to move	Major
cities	Inner regional	Outer regional	Remote and very remote	Total	N	
Into permanent RAC from hospital	Row per cent		
Major cities	96.5	3.2	0.3	—	100.0	14,172	
Inner regional	9.7	87.0	3.1	0.1	100.0	4,243	
Outer regional	3.0	11.6	85.1	0.3	100.0	1,497	
Remote and very remote	13.4	6.3	15.2	65.2	100.0	112	
All	70.7	21.6	7.3	0.4	100.0	. .	
Total admissions (number)	14,148	4,324	1,465	87	. .	20,024	
Into permanent RAC from community							
Major cities	95.3	3.9	0.6	0.1	100.0	12,369	
Inner regional	11.0	86.0	2.8	0.2	100.0	4,150	
Outer regional	4.9	9.2	85.4	0.5	100.0	1,458	
Remote and very remote	8.3	7.0	12.1	72.6	100.0	157	
All	68.0	23.1	8.0	0.8	100.0	. .	
Total admissions (number)	12,335	4,196	1,459	144	. .	18,134	
Transfer into permanent RAC							
Major cities	95.0	4.4	0.6	0.1	100.0	13,606	
Inner regional	10.1	86.8	3.0	0.1	100.0	3,963	
Outer regional	3.2	7.8	88.6	0.4	100.0	1,690	
Remote and very remote	5.2	3.5	12.1	79.2	100.0	173	
All	68.9	21.5	8.9	0.8	100.0	. .	
Total admissions (number)	13,383	4,173	1,721	155	. .	19,432	
All into permanent RAC							
Major cities	95.6	3.8	0.5	0.1	100.0	40,147	
Inner regional	10.3	86.6	3.0	0.2	100.0	12,356	
Outer regional	3.7	9.5	86.5	0.4	100.0	4,645	
Remote and very remote	8.4	5.4	12.9	73.3	100.0	442	
All	69.2	22.0	8.1	0.7	100.0	. .	
Total admissions (number)	39,866	12,693	4,645	386	. .	57,590	
						(continued)	
Table 4.5 (continued): RAC entries for people aged 65+: remoteness of person prior to admission into RAC, by remoteness of RAC facility and movement type, 2001–02 (unadjusted)
	Remoteness of RAC facility		
Movement type/remoteness of usual residence prior to move	Major cities	Inner regional	Outer regional	Remote and very remote	Total	N	
Into respite RAC from hospital	Row per cent		
Major cities	95.8	3.8	0.4	0.1	100.0	4,554	
Inner regional	7.6	88.6	3.7	<0.2	100.0	2,019	
Outer regional	<2.0	8.8	89.1	<0.5	100.0	992	
Remote and very remote	<8.1	<4.1	11.4	82.9	100.0	123	
All	59.0	26.7	12.9	1.4	100.0	. .	
Total admissions (number)	4,537	2,052	988	111	. .	7,688	
Into respite RAC from community							
Major cities	94.8	4.7	0.5	—	100.0	20,244	
Inner regional	8.5	88.3	3.1	0.1	100.0	8,850	
Outer regional	2.1	13.0	84.5	0.4	100.0	3,133	
Remote and very remote	5.9	3.7	14.9	75.5	100.0	404	
All	61.4	28.2	9.4	1.0	100.0	. .	
Total admissions (number)	20,026	9,191	3,077	337	. .	32,631	
Transfer into respite RAC							
Major cities	>92.6	6.4	0.5	<0.5	100.0	944	
Inner regional	15.4	79.6	5.0	—	100.0	319	
Outer regional	16.5	11.0	72.5	—	100.0	91	
Remote and very remote	<31.3	—	—	>68.8	100.0	16	
All	68.8	23.6	6.4	1.2	100.0	. .	
Total admissions (number)	943	324	87	16	. .	1,370	
All into respite RAC							
Major cities	94.9	4.6	0.5	—	100.0	25,742	
Inner regional	8.5	88.1	3.2	0.1	100.0	11,188	
Outer regional	2.3	12.0	85.3	0.4	100.0	4,216	
Remote and very remote	5.5	3.1	13.6	77.7	100.0	543	
All	61.2	27.7	10.0	1.1	100.0	. .	
Total admissions (number)	25,506	11,567	4,152	464	. .	41,689	
All movements							
Major cities	95.3	4.1	0.5	0.1	100.0	65,889	
Inner regional	9.5	87.3	3.1	0.1	100.0	23,544	
Outer regional	3.0	10.7	85.9	0.4	100.0	8,861	
Remote and very remote	6.8	4.2	13.3	75.7	100.0	985	
All	65.8	24.4	8.9	0.9	100.0	. .	
Total admissions (number)	65,372	24,260	8,797	850	. .	99,279	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer. 
3.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the ABS (ABS 2001b).
4.	628 records were excluded due to missing postcodes for remoteness coding.

5	Analysis of person outcomes
5.1	Factors affecting entry into RAC from hospital
Of particular interest is whether personal characteristics and a person’s experience in hospital can help predict whether they will be admitted to RAC when they are discharged from hospital. Identifying whether a range of factors influence the outcome can be done using logistic regression models. Fitting such models allows us to bring together the various elements considered individually in Section 3 so that factors underlying observed differences in entry into RAC from hospital can be identified.
Two logistic regression models were fitted to identify, firstly, factors associated with whether a person was admitted to RAC on leaving hospital, and, secondly, if they were admitted to RAC whether they went into permanent or respite care. The two models are:
•	Model A for people who returned to the community or were admitted into RAC following discharge from hospital. This model estimates the probability that a person in hospital would be admitted to RAC rather than return to the community.
•	Model B for people who were admitted into RAC following discharge from hospital. This model estimates the probability that a person in hospital would be admitted into permanent rather than respite RAC, given that it was known that the person would be moving into RAC from hospital.
Note that as we are interested only in people who could possibly be admitted into RAC, people identified as either dying in hospital or returning to RAC from hospital were excluded from both models. Variables used in the analysis were:
•	age at hospital admission
•	sex
•	state/territory of hospital
•	remoteness of usual residence (prior to hospitalisation)
•	marital status
•	English proficiency (EP) group, which is based on reported country of birth using the 2001 classification of countries into English Proficiency Groups (see Appendix D)
•	hospital sector
•	care type in hospital prior to discharge
•	hospital mode of admission
•	length of hospital episode
•	principal diagnosis
•	presence or absence of specific diseases as additional diagnoses.
Results from fitting the above models are summarised below. An explanation of logistic regression models, interpretation of results, specifications of the variables used for models A and B and the final fitted models are given in Appendix E. Models were fitted using unadjusted data.
5.1.1	Propensity to be discharged to RAC 
An estimated 845,000 people aged 65 years and over were discharged from hospital either to be admitted into RAC (respite and permanent) or to return to the community. Of these, 3.6% were admitted into RAC directly following discharge from hospital.
When fitting Model A, the most significant predictors of entry into RAC rather than a return to the community from hospital were:
•	principal diagnosis
•	an additional diagnosis of ‘Awaiting admission elsewhere’
•	the duration of the hospital episode before discharge
•	age
•	an additional diagnosis of dementia and related disorders
•	hospital mode of admission (that is, from within the hospital system or from the community)
•	state or territory of hospital admission
•	hospital care type prior to discharge. 
Marital status and EP group also had statistically significant effects (see Table E.1 for fitted Model A).
A summary of the main results from the logistic regression model is given below. The effects of particular variables can be seen by comparing predicted probabilities of being admitted into RAC (as opposed to the community). Such comparisons are most easily understood in reference to a person with specific characteristics. The probabilities then relate to a person with characteristics the same as those of the ‘reference’ person except for the difference in the single variable whose effect is being considered. 
The characteristics of the reference person used for the following discussion are described in Box 5.1. These values were chosen because in most cases for each variable they were the most common. The traits of this person (in particular that she was aged 75, was discharged from acute care after a short stay for treatment for a tumour or cancer) mean that she was unlikely to have been admitted into RAC on discharge from hospital: the predicted probability of this happening is 0.4%, compared with an observed rate of discharge to RAC across all discharges of 3.6%. In the discussion below, the effect of a particular variable on the predicted probability of discharge to RAC is illustrated by comparing the predicted probability for the reference person (0.4%) with that for an adjusted reference person, where the adjusted reference person differs from the reference person in only the single characteristic being discussed.
If a person differs from the reference person in several characteristics much larger differences in the predicted probabilities would be observed. For example, a person who was different from the reference person by being aged 85, widowed, with a principal diagnosis of dementia, in hospital for 8 to 12 weeks in GEM after changing care type (that is, a statistical admission), has a predicted probability of 83% and so would have been highly likely to have been discharged to RAC. 
Model A reflects the relationships seen in other analyses in this report between principal diagnosis and transition into RAC (see tables 3.16 and 6.2). People with a principal diagnosis of ‘Awaiting admission elsewhere’ or ‘Dementia and related disorders’ have the highest predicted probabilities of admission into RAC (5.2% and 3.9%for reference person adjusted with respect to principal diagnosis to these two categories respectively) (Table E.1). Not surprisingly, given the effect of principal diagnosis upon RAC admission, additional diagnoses of ‘Awaiting admission elsewhere’ and ‘Dementia and related disorders’ were also associated with an increased likelihood of being admitted to RAC from hospital rather than returning to the community—by nearly 12 times and just over 3 times, respectively 
(Table E.1).

Box 5.1:	Reference person for comparison for Model A (discharge to community or RAC admission)
For this analysis the reference person used for comparing predicted probabilities has the following characteristics:
•	75 years old at admission into hospital
•	female
•	married/de facto
•	born in Australia
•	usual residence in a major city
•	admitted to a hospital in New South Wales
•	in a public hospital
•	hospital mode of admission was not a transfer from another hospital or the result of a change in 
care type
•	receiving acute care in hospital
•	hospital episode duration of less than 1 week
•	a principal diagnosis of neoplasm.
These values were chosen because in most cases within each variable they were the most common.
The predicted probability of this person being admitted to RAC from hospital is low at 0.4%. Therefore the predicted probability of this person returning to the community is 99.6%. Details of how to calculate predicted probabilities of admission into RAC for other combinations of variable values are given in Appendix E.  

Longer hospital episodes were associated with an increased likelihood of admission into RAC rather than a return to the community (Table E.1). The reference person, with a hospital episode prior to discharge lasting for less than 1 week, has a 0.4% predicted probability of entering RAC. This compares with a predicted probability of 1.5% if the episode had lasted for 1–4 weeks, 4.3% if it had been for 4–8 weeks and rising to 7% if the episode had been for 
12 weeks or more. These results are consistent with the analysis of length of stay by movement type (Table 3.5), where the median length of stay in hospital was 24 days for people moving into permanent RAC, 14 days for people moving into respite RAC, and 4 days for people returning to the community.
As expected, older age was associated with an increased likelihood of entering RAC from hospital rather than returning to the community (Table E.1). A 65 year-old was nearly half as likely to be discharged to RAC ( 0.2% predicted probability for adjusted reference person) as a 75 year old, while a  95 year-old was over four times as likely to have this destination (1.8% predicted probability for adjusted reference person). This ties in well with earlier analysis (Table 3.6), which indicated that people moving into RAC from hospital had an older age profile than those returning to the community.  
People whose final episode in hospital began with a change in care type or a hospital transfer were more likely to be admitted into RAC following discharge than people with a final episode which began with admission from outside the hospital system (Table E.1). For example, if the discharge episode for our reference person had begun with a transfer between hospitals rather than with entry into the hospital system, her predicted probability of discharge to RAC would be 1.5 times higher (0.6% versus 0.4%), while if it had begun with a change in care type the predicted probability would be 2.4 times greater (0.9%).
Care type in hospital prior to discharge was associated with the likelihood of entering RAC from hospital (Table E.1). People who received palliative care, maintenance care or other/unknown care prior to discharge were more likely to be admitted to RAC than people who received acute care prior to discharge. On the other hand, people receiving rehabilitation care were less likely than those receiving acute care to be admitted to RAC. Consequently, our reference person, who had received acute care prior to discharge, has a 0.4% predicted probability of entering permanent RAC, compared with 1.1% for an adjusted reference person receiving palliative care and 0.6% for someone receiving maintenance or other/unknown care. People receiving rehabilitation care prior to discharge were nearly half as likely to be admitted to RAC as people receiving acute care (see also Table 3.16).
The probability of admission to RAC also varied with state or territory of hospital admission (Table E.1). For example, our reference person using a hospital in New South Wales or South Australia has the highest predicted probability of being admitted into RAC (0.4%) when compared with her counterparts in hospitals in Victoria (0.3%) and the other states and territories (0.2%). This result suggests that jurisdictional differences in care services provision and/or practices could be affecting post-hospital destination.
Whether or not a person has a partner provides an indication of the availability of care at home on return from hospital (although, for older people, partners themselves may need assistance). People who were married or in a de facto relationship were less likely than other people to be admitted to RAC (Table E.1), with people who had never married being the most likely to be discharged to RAC (predicted probability of 0.7% for adjusted reference person).
People with the highest levels of English proficiency were more likely than others to be admitted to RAC (Table E.1). In particular, people born in countries in the lowest EP group (EP 4) have the lowest predicted probability of RAC admission (0.2% for adjusted reference person).
5.1.2	Discharge to permanent rather than respite RAC
An estimated 30,400 people aged 65 years and over moved into RAC from hospital (excluding returns to RAC) (Table 1.3). Of these, nearly three-quarters (72%) moved into permanent RAC.
When fitting Model B the most significant predictors of admission into permanent rather than respite RAC from hospital were:
•	hospital care type prior to discharge
•	the duration of the hospital episode before discharge
•	principal diagnosis
•	an additional diagnosis of ‘Awaiting admission elsewhere’
•	region of usual residence prior to hospital admission
•	state or territory of hospital admission
•	an additional diagnosis of dementia and related disorders.
Although important for the prediction of entry into RAC as opposed to return to the community, a patient’s marital status, sex and EP group were not significant predictors of entry into permanent rather than respite RAC. 
A summary of the main results from the logistic regression model is given below; details of Model B as fitted are given in Table E.2. As before, predicted probabilities based on a ‘reference’ person are used to aid the discussion, with the probability relating to being admitted into permanent rather than respite RAC. The characteristics chosen for the reference person, again selected because they were the most common, are given in Box 5.2. Someone with the same characteristics as the reference person has a predicted probability of 63% of entering permanent rather than respite residential care, compared with the observed rate of 72% across all admissions from hospital. As when discussing Model A, the effect of a particular variable on the predicted probability is illustrated by comparing the predicted probability for the reference person with that for an adjusted reference person, where the adjusted reference person differs from the reference person in only the single characteristic being discussed.
The probability of being admitted into permanent rather than respite care varied considerably with a person’s circumstances. This can be seen by considering two people who differed from the reference person in several characteristics. For example, an 85 year old woman in hospital in Tasmania for a stroke who was in rehabilitative care for 10 weeks before being admitted into RAC was highly likely to have gone into permanent care, with a predicted probability of over 95% for being admitted into permanent rather than respite care. On the other hand, a 75 year old man living in an outer regional area prior to admission to a Queensland hospital because of a fall and who had 4 weeks in rehabilitative care prior to discharge to RAC was more likely to go into respite rather than permanent care, having a predicted probability of 34% for having a permanent RAC admission.
The results from Model B show that care type in hospital prior to discharge was associated with the likelihood of entering permanent RAC from hospital (Table E.2). People who received palliative care, GEM or maintenance care prior to discharge were more likely to enter permanent RAC than people who received acute care prior to discharge. Consequently, at 63% the reference person has a relatively low predicted probability of entering permanent RAC, compared with 71% for an adjusted reference person discharged from maintenance care, and 77% and 80% for adjusted reference persons discharged from GEM and palliative care, respectively. These higher probabilities reflect earlier results: GEM and palliative care both have higher ratios of permanent to respite admissions than acute care (Table 3.11).

Box 5.2:		Reference person for comparison for Model B (discharge to permanent or respite RAC admission)
For this analysis the reference person has the following characteristics:
•	85 years old at admission
•	female
•	married/de facto
•	born in Australia
•	usual residence in a major city
•	admitted to a hospital in New South Wales
•	in a public hospital
•	hospital admission was not a change in care type or transfer
•	receiving acute care in hospital
•	hospital episode duration of more than 1 week and less than 4 weeks
•	a principal diagnosis of neoplasm.
These values were chosen because in most cases within each variable they were the most common among people in the analysis.
Given that this reference person is being discharged to RAC, the predicted probability of them being admitted to permanent RAC from hospital is 62.5%. Hence, the predicted probability of this person being admitted into respite RAC is 37.5%. Details of how to calculate predicted probabilities of admission into permanent RAC for other combinations of variable values are given in Appendix E.  

The longer a person’s last hospital episode before RAC admission, the greater the likelihood was that he or she would be admitted to permanent RAC rather than respite RAC (Table E.2). For example, an adjusted reference person whose final hospital episode lasted for less than a week has a 50% predicted probability of entering permanent RAC and so is predicted to be just as likely to enter respite as permanent RAC. The predicted probability increases to 86% for an adjusted reference person who was discharged following a hospital episode lasting longer than 12 weeks. This result is as expected given that people admitted into permanent RAC had a median length of stay in hospital of 24 days compared with 14 days for people admitted into respite RAC (Table 3.13).
People with a principal diagnosis among stroke, dementia and related disorders or ‘Awaiting admission elsewhere’ have relatively high predicted probabilities of permanent RAC admission (adjusted reference person probabilities of 75%, 74% and 73%, respectively). Principal diagnoses for which people have relatively low predicted probabilities of permanent RAC admission (and therefore a relatively high probability of entering respite RAC) include injury caused by a fall (53% for adjusted reference person), other mental and behavioural disorders (excluding dementia and related disorders) (52%) and factors influencing health status (excluding ‘Awaiting admission elsewhere’) (48%).
A person with an additional diagnosis of ‘awaiting admission elsewhere’ had an increased probability of being admitted into permanent rather than respite RAC. For example, an adjusted reference person with this additional diagnosis has a 78% predicted probability of being admitted to permanent RAC compared with 63% for the reference person.
A person with an additional diagnosis of dementia and related disorders was more likely than someone without this diagnosis to be admitted into permanent RAC. Thus an adjusted reference person with this additional diagnosis has a 74% predicted probability of being admitted to permanent RAC.  
A person living in an inner regional, outer regional or remote area before going to hospital was less likely to be admitted into permanent RAC than someone living in a major city prior to hospitalisation (Table E.2). As a result, the estimated probability drops from 63% to less than 50% for an adjusted reference person coming from an inner regional, outer regional or remote area.
State or territory of the hospital plays a significant role in predicting someone’s admission into permanent RAC (Table E.2). For example, people discharged from a hospital in the Australian Capital Territory have the lowest predicted probability of being admitted into permanent RAC (45% for adjusted reference person), while people using Tasmanian hospitals have the highest (88%). This is consistent with the data regarding ratios of permanent to respite admissions presented in Table 2.3. These last two results indicate that variation in jurisdictional and regional aged care service provision and/or practices may influence the outcome.
5.2	Short-term use of residential aged care following a period in hospital
A question of particular interest from a policy perspective is what happens to people who enter RAC from hospital: do they remain in aged care or do they return to the community? If they return to the community, do they remain there, or are they re-admitted into RAC soon after? The answers to these questions provide information on whether RAC episodes following hospitalisation, particularly in respite care, are to aid recovery following hospitalisation or to facilitate a transition into permanent residential care. 
To provide insight into these issues, transitions following a person’s first move from hospital to RAC in 2001–02 were analysed using the following framework:
•	People were said to have returned to the community if they did so within 12 weeks of their admission from hospital into RAC. A time of 12 weeks was used to set the cut-off because in general over 90% of respite stays are shorter than this (AIHW 2005:table A4.4). In addition, 12 weeks allows for one extension period following the initial approval for up to 63 days of residential respite care in a financial year (Box 1.2).
•	If a person returned to the community within 12 weeks, a further assessment of the success of this move was made by seeing whether they returned to RAC within the following 4 weeks. Note that people may have died during the 4-week period but it was not possible to determine the number of such cases. In addition, some people also reported that they were moving to another aged care service yet were not identified in the ACCMIS data as having been re-admitted to any service within the 4 weeks.
•	For people who did not return to the community within 12 weeks, their status at the 
12-week mark was identified as:
–	being in respite RAC
–	being in permanent RAC
–	discharged to hospital within the 12 weeks, or
–	died in RAC within the 12 weeks. 
Some examples of transition events are illustrated in Figure 5.1. Because a 16-week window was required to identify a successful return to the community, only hospital–RAC transition events occurring in the first 36 weeks of 2001–02 could be used to analyse returns and 
non-returns to the community.

Figure 5.1:	Short-term use of RAC: example pathways
Diagram showing example pathways of short term use of RAC. These pathways include: returned to the community within 12 weeks, and then returned to RAC within 4 weeks; returned to the community within 12 weeks, and did not return to RAC within 4 weeks; in permanent RAX after 12 weeks; discharged to hospital within 12 weeks; and died in RAC within 12 weeks.
5.2.1	Type of RAC admission
As expected, the situation of people 12 weeks after their admission to RAC from hospital differed according to whether they were admitted into respite or permanent care (Table 5.1, Figure 5.2). Over one-half (59%) of people who were admitted into respite care returned to the community within 12 weeks; 10% of this group (that is, 6% of all with respite admissions) were re-admitted into RAC within 4 weeks of returning to the community. Of those not 
re-admitted within 4 weeks, one-fifth (22%, or 11% of all respite admissions) left RAC reporting they were going to another RAC service but had not been re-admitted within 4 weeks of returning to the community. 
Just 9% of people who were admitted into permanent care returned to the community within 12 weeks, and about 11% of this group (129 of 1,190) were re-admitted into RAC within 
4 weeks (Table 5.1). Around 14% of those who returned to the community within 12 weeks also reported they were going to another RAC service but had not been re-admitted within 
4 weeks of returning to the community. 
More than two-thirds (71%) of people admitted to permanent care were still living in RAC after 12 weeks, compared with 24% of people admitted to respite care (Table 5.1). In addition, 4% of this latter group (56 people) had transferred into permanent care within the 12 weeks. People admitted into respite care from hospital were less likely to die but more likely to be discharged to hospital within 12 weeks than those admitted into permanent care (6% versus 19% and 11% versus 2%, respectively; both differences statistically significant with p<0.01). 
Of particular interest are the within-RAC transfer rates for people who were admitted to respite care from hospital and who were still in RAC after 12 weeks. Analysis of the RAC data has shown that among RAC admissions in 2001–02, the level of respite and permanent RAC non-transfer admissions were about equal (48% and 52%, respectively) (AIHW 2003c). In addition, approximately 20% of all respite admissions during 2001–02 subsequently resulted in a transfer to permanent care (unpublished AIHW analysis). However, Table 5.1 shows that among all respite admissions from hospital only 1% resulted in a transfer to permanent care within 12 weeks, and for those people entering RAC from hospital, far fewer people were admitted into respite care than permanent care (28% versus 72%, Table 5.1). That is, nearly three-quarters of people entering RAC from hospital were admitted into permanent RAC, compared with just over half for all non-transfer admissions. These differences suggest that people moving into respite care from hospital have different care needs and characteristics from people entering residential respite care from the community. 
This tendency for people from hospital to be admitted into permanent rather than respite care is supported by data from the Aged Care Assessment Program Minimum Data Set annual report. Among 2003–04 assessments, clients were twice as likely to be recommended to permanent RAC if assessed in hospital than if assessed elsewhere (Aged Care Assessment Program National Data Repository 2005); that is, people were less likely to be assessed as having the capacity to return home when assessed in hospital. Whether this assessment is accurate is unknown, but it is possible that the deconditioning that can occur in hospital affects assessment outcomes (see references in AIHW: Karmel et al. 2007b).
The small percentage of people entering respite care who transferred to permanent care within 12 weeks (1%) and the high percentage returning to the community within 12 weeks (59%) suggests that, in 2001–02, for people leaving hospital respite RAC was being used at least to some extent as transition care before going back to the community. In addition, the relatively high proportion still in care at 12 weeks indicates that rehabilitative care can require long stays in respite care.
Figure 5.2:	Movement of people after admission to RAC from hospital, 2001–02
Two horizontal bar charts showing movement of people after admission on y-axes and ‘% into respite RAC’ and ‘% into permanent RAC’ on x-axes.
Source: Table 5.1.

5.2.2	Regional differences
The pattern of returns to the community varied with state and territory (Table 5.1). The proportion of people with a post-hospital respite admission who returned to the community within 12 weeks ranged from 51% for South Australia to around 70% for Victoria and Tasmania. However, there was less variation in the proportion of these community returns with a re-admission into RAC within 4 weeks, with re-admission rates varying between 7% and 13% of community returns (excluding the Northern Territory). Rates of discharge to hospital and death while in respite care also varied with jurisdiction.
As seen previously, the proportion of admissions from hospital which were for permanent care fluctuated across the states and territories. Tasmania had the highest proportion of people moving into permanent rather than respite care: 89% compared with 56% for the Australian Capital Territory. However, there was less variation across the jurisdictions in the proportion of people returning to the community after permanent admissions than there was after respite admissions. After permanent admission from hospital, people returned to the community for between 7% and 12% of cases. Similar to respite admissions, and depending on the jurisdiction, re-admission into RAC within 4 weeks occurred for between 9% and 15% of those who had left, which in each case was about 1% of all people with a permanent admission. There was little variation in the proportion of permanent admissions ending with discharge to hospital. However, death in RAC within 12 weeks of permanent admission from hospital ranged from 16% in Victoria to 22% in South Australia (25% in the Australian Capital Territory, based on 93 cases). Overall, the proportion of people still in RAC 12 weeks after a permanent admission from hospital varied within four percentage points around 70% across all states and territories.
Differences in patterns of return to the community were more marked between jurisdictions than between remoteness regions (tables 5.1 and 5.2). The most striking difference was the decreasing relative use of permanent admissions as the remoteness of the RAC facility increased: for facilities in major cities 75% of people admitted from hospital went into permanent care compared with under 50% for those in remote and very remote regions (see also Table 2.6). On the other hand, the proportion of people who returned to the community within 12 weeks of being admitted to respite care from hospital was relatively low for facilities in remote and very remote areas (53% compared to 59% overall). The models on discharge into RAC discussed in Section 5.1 also pointed to this pattern, showing that people from more remote regions were less likely than others to be discharged into RAC, and that the resulting admission into care was even less likely to be for permanent RAC as remoteness increased. This pattern could result from a number of factors, including the availability of residential care in a person’s local region, the availability of community care and the need to ensure that a person can cope once they return to a home that may be a long way from emergency services.
Table 5.1:	People aged 65+ returning to the community following RAC admission from hospital, by admission type and state/territory of usual residence, 2001–02 (unadjusted)
Admission type/movement following admission to RAC	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
Transition into respite RAC	Column per cent		
Returned to the community within 12 weeks											
Did not return to RAC within 4 weeks											
Left reported going to RAC	14.5	9.1	8.0	14.1	10.2	n.p.	9.5	n.p.	11.7	633	
Other	37.7	53.1	42.7	38.3	35.7	n.p.	51.4	n.p.	41.2	2,238	
Subtotal	52.2	62.2	50.7	52.4	45.9	>58.1	60.8	n.p.	52.9	2,871	
Returned to RAC within 4 weeks 											
Readmission into respite RAC	3.4	7.1	5.9	4.2	3.9	n.p.	n.p.	n.p.	4.7	253	
Readmission into permanent RAC	0.9	1.3	1.4	—	0.7	n.p.	n.p.	n.p.	1.0	52	
Subtotal	4.3	8.3	7.4	4.2	4.6	<11.6	6.8	n.p.	5.6	305	
Total returners to the community	56.4	70.5	58.0	56.6	50.5	69.8	67.6	>64.3	58.5	3,176	
Did not return to the community within 12 weeks											
In respite RAC after 12 weeks	26.1	15.1	18.9	26.9	28.6	23.3	18.9	n.p.	23.3	1,264	
In permanent RAC after 12 weeks	1.1	0.9	1.0	1.1	1.2	—	—	n.p.	1.0	56	
Discharged to hospital within 12 weeks	11.0	9.0	15.2	11.2	10.7	n.p.	n.p.	n.p.	11.3	615	
Died in RAC within 12 weeks	5.4	4.4	6.8	4.2	9.0	n.p.	n.p.	n.p.	5.8	316	
Total non-returners to the community 	43.6	29.5	42.0	43.4	49.5	30.2	32.4	<35.7	41.5	2,251	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total (people)	2,274	865	993	475	689	43	74	14	. .	5,427	
Transition into permanent RAC										
	
Returned to the community within 12 weeks											
Did not return to RAC within 4 weeks											
Left reported going to RAC	2.0	0.8	0.6	0.8	0.6	n.p.	n.p.	n.p.	1.2	163	
Other	6.2	6.6	6.5	6.1	5.8	n.p.	n.p.	n.p.	6.4	898	
Subtotal	8.2	7.4	7.1	6.9	6.4	>10.7	7.5	n.p.	7.6	1,061	
Returned to RAC within 4 weeks 											
Readmission into respite RAC	—	—	—	—	—	n.p.	—	n.p.	—	—	
Readmission into permanent RAC	0.8	0.7	1.3	1.2	0.8	n.p.	—	n.p.	0.9	129	
Subtotal	0.8	0.7	1.3	1.2	0.8	<1.4	—	n.p.	0.9	129	
Total returners to the community	9.0	8.1	8.4	8.1	7.3	12.1	7.5	n.p.	8.5	1,190	
Did not return to the community within 12 weeks											
In respite RAC after 12 weeks	—	—	—	—	—	—	—	n.p.	—	—	
In permanent RAC after 12 weeks	67.6	74.4	72.3	72.4	69.2	70.2	66.7	n.p.	70.9	9,897	
Discharged to hospital within 12 weeks	1.8	1.7	2.0	3.0	1.4	<1.4	<5.4	n.p.	1.9	260	
Died in RAC within 12 weeks	21.5	15.7	17.2	16.4	22.1	>16.2	>20.4	n.p.	18.8	2,621	
Total non-returners to the community 	91.0	91.9	91.6	91.9	92.7	87.9	92.5	n.p.	91.5	12,788	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total (people)	4,955	3,853	2,393	997	1,321	346	93	10	. .	13,968	
Per cent transitions into permanent RAC (% people with transition)	68.5	81.7	70.7	67.7	65.7	88.9	55.7	41.7	. .	72.0	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of initial RAC admission from hospital. 
3.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.
Table 5.2:	People aged 65+ returning to the community following RAC admission from hospital, by admission type and region of RAC facility, 2001–02 (unadjusted)
Admission type/Movement following admission to RAC	Major cities	Inner regional	Outer regional	Remote and very remote	Australia	N	
Transition into respite RAC	Column per cent	
Returned to the community within 12 weeks							
Did not return to RAC within 4 weeks							
Left reported going to RAC	12.4	9.1	13.8	11.4	11.7	633	
Other	42.0	40.7	39.5	36.4	41.2	2,237	
Subtotal	54.4	49.8	53.3	47.7	52.9	2,870	
Returned to RAC within 4 weeks 							
Readmission into respite RAC	3.9	6.4	4.7	n.p.	4.7	253	
Readmission into permanent RAC	0.7	1.5	0.9	n.p.	1.0	52	
Subtotal	4.6	7.8	5.6	5.7	5.6	305	
Total returners to the community	59.0	57.6	58.9	53.4	58.5	3,175	
Did not return to the community within 12 weeks							
In respite RAC after 12 weeks	24.0	22.1	21.4	31.8	23.3	1,263	
In permanent RAC after 12 weeks	1.1	0.8	1.5	—	1.0	56	
Discharged to hospital within 12 weeks	10.7	13.2	11.3	6.8	11.3	615	
Died in RAC within 12 weeks	5.3	6.3	7.0	8.0	5.8	316	
Total non-returners to the community 	41.0	42.4	41.1	46.6	41.5	2,250	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total (people)	3,220	1,443	674	       88 	. .	5,425	
Transition into permanent RAC							
Returned to the community within 12 weeks							
Did not return to RAC within 4 weeks							
Left reported going to RAC	1.2	1.0	1.2	n.p.	1.2	163	
Other	6.3	7.4	5.6	n.p.	6.4	898	
Subtotal	7.5	8.4	6.8	n.p.	7.6	1,061	
Returned to RAC within 4 weeks 							
Readmission into respite RAC	—	—	—	—	—	—	
Readmission into permanent RAC	0.8	1.2	1.1	n.p.	0.9	129	
Subtotal	0.8	1.2	1.1	n.p.	0.9	129	
Total returners to the community	8.3	9.6	7.9	<5.7	8.5	1,190	
Did not return to the community within 12 weeks							
In respite RAC after 12 weeks	—	—	—	—	—	—	
In permanent RAC after 12 weeks	70.7	71.2	71.0	82.0	70.9	9,896	
Discharged to hospital within 12 weeks	2.0	1.3	2.2	n.p.	1.9	260	
Died in RAC within 12 weeks	19.0	17.9	19.0	n.p.	18.8	2,621	
Total non-returners to the community 	91.7	90.4	92.1	>94.3	91.5	12,777	
Total	100.0	100.0	100.0	100.0	100.0	. .	
Total (people)	9,866	3,024	1,016	      61 	. .	13,967	
Per cent transitions into permanent RAC 
(% people with transition)	75.4	67.7	60.1	   40.9 	. .	72.0	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of initial RAC admission from hospital. 
3.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.
4.	The table uses the Australian Standard Geographical Classification Remoteness Structure as developed by the ABS.
5.	Three records were excluded due to missing valid postcodes for remoteness coding. 
5.2.3	Age and sex differences
While not large, there were some differences in patterns in returns to the community by sex and age (Table 5.3). The proportion of people admitted to respite care from hospital who returned to the community was very similar for men and women (58% and 59%, respectively). However, women were slightly less likely than men either to have been discharged to hospital or to have died while in care (11% versus 13% and 6% versus 7%, respectively). There were also some age differences evident, with older people being less likely to return to the community than younger people (57% for men aged 65–79 compared with 60% for men aged 80+, and 57% and 63%, respectively, for women in the two age groups).
For admissions into permanent care, there were only minor differences by sex and age in the proportions of admissions followed by a return to the community. However, while men were slightly more likely than women to return to the community within 12 weeks of a permanent admission from hospital (9.4% versus 8.5%, p<0.01), the women who returned to the community were more likely to be re-admitted to RAC within 4 weeks (14% of women who left were re-admitted compared with 7% of men). Women were less likely to die within 12 weeks of admission (16% of women versus 23% of men) and overall were more likely to still be in permanent RAC than men at the 12 week point (74% versus 65%).
5.2.4	Care needs
As seen before in Section 4.3, people admitted into respite care on average had lower care needs than those admitted into permanent care: 44% of people admitted into low care from hospital went into permanent care compared with 82% of those admitted into high care 
(Table 5.4). People admitted into respite care with low-care needs from hospital were much more likely to return to the community than those with high-care needs (68% versus 48% of admissions). In addition, those who returned to the community were less likely to return within 4 weeks (8% compared with 12%). Furthermore, those with low-care needs were less likely either to die while in care (9% compared with 14%) or to be discharged to hospital 
(3% versus 10%). 
Among people admitted permanently into RAC from hospital, the rate of returning to the community was not significantly different for people with low- and high-care needs. The main difference between the outcomes for low and high-care residents was in the proportion dying within 12 weeks: 21% of people admitted from hospital with high-care needs died within 
12 weeks compared with 6% of those for people admitted with low-care needs.
Table 5.3:	People aged 65+ returning to the community following RAC admission from hospital, by age, sex and admission type, 2001–02 (unadjusted)
Admission type/movement following admission to RAC	Male		Female			
	65–79	80+	All		65–79	80+	All	All	N	
Transition into respite RAC	Column per cent		
Returned to the community within 12 weeks			
Did not return to RAC within 4 weeks										
Left reported going to RAC	12.4	11.0	11.6		9.3	12.6	11.7	11.7	633	
Other	42.2	40.5	41.2		47.7	38.7	41.3	41.2	2,238	
Subtotal	54.6	51.6	52.8		57.0	51.4	53.0	52.9	2,871	
Returned to RAC within 4 weeks 										
Readmission into respite RAC	4.4	4.4	4.4		4.8	4.8	4.8	4.7	253	
Readmission into permanent RAC	0.7	1.0	0.9		1.0	1.0	1.0	1.0	52	
Subtotal	5.1	5.5	5.3		5.8	5.8	5.8	5.6	305	
Total returns to the community	59.7	57.0	58.1		62.9	57.1	58.8	58.5	3,176	
Did not return to the community within 12 weeks										
In respite RAC after 12 weeks	19.5	21.7	20.8		21.2	26.0	24.6	23.3	1,264	
In permanent RAC after 12 weeks	1.0	1.3	1.2		0.8	1.0	0.9	1.0	56	
Discharged to hospital within 12 weeks	12.9	12.3	12.6		10.0	10.9	10.7	11.3	615	
Died in RAC within 12 weeks	6.9	7.6	7.3		5.1	5.0	5.0	5.8	316	
Total non-returners to the community 	40.3	43.0	41.9		37.1	42.9	41.2	41.5	2,251	
Total	100.0	100.0	100.0		100.0	100.0	100.0	100.0	. .	
Total (people)	766	1,150	1,916		996	2,515	3,511	. .	5,427	
Transition into permanent RAC	Column per cent		
Returned to the community within 12 weeks										
Did not return to RAC within 4 weeks										
Left reported going to RAC	1.5	1.1	1.2		1.1	1.1	1.1	1.2	163	
Other	7.9	7.1	7.4		5.9	5.8	5.8	6.4	898	
Subtotal	9.5	8.2	8.7		7.0	6.9	6.9	7.6	1,061	
Returned to RAC within 4 weeks 										
Readmission into respite RAC	—	—	—		—	—	—	—	—	
Readmission into permanent RAC	0.9	0.6	0.7		1.4	0.9	1.0	0.9	129	
Subtotal	0.9	0.6	0.7		1.4	0.9	1.0	0.9	129	
Total returns to the community	10.4	8.8	9.4		8.3	7.8	8.0	8.5	1,190	
Did not return to the community within 12 weeks										
In respite RAC after 12 weeks	—	—	—		—	—	—	—	—	
In permanent RAC after 12 weeks	66.7	64.6	65.4		74.7	74.0	74.2	70.9	9,897	
Discharged to hospital within 12 weeks	2.0	2.1	2.1		1.9	1.7	1.7	1.9	260	
Died in RAC within 12 weeks	20.8	24.5	23.1		15.1	16.4	16.1	18.8	2,621	
Total non-returners to the community 	89.6	91.2	90.6		91.7	92.2	92.0	91.5	12,788	
Total	100.0	100.0	100.0		100.0	100.0	100.0	100.0	. .	
Total (people)	2,017	3,294	5,311		2,108	6,549	8,657	. .	13,968	
Per cent transitions into permanent RAC 
(% people with transition)	72.5	74.1	73.5		67.9	72.3	71.1	. .	72.0	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of initial RAC admission from hospital. 
3.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.
Table 5.4:	People aged 65+ returning to the community following RAC admission from hospital, by care level and admission type, 2001–02 (unadjusted)
Admission type/movement following admission to RAC	Transition into respite RAC		Transition into permanent RAC			
	Low
care	High care	All		Low care	High care	All	All	N	
Returned to the community within 12 weeks	Column per cent		
Did not return to RAC within 4 weeks										
Left reported going to RAC	14.5	8.6	11.7		1.2	1.2	1.2	4.1	796	
Other	48.2	33.6	41.2		6.7	6.4	6.4	16.2	3,136	
Subtotal	62.6	42.2	52.9		7.8	7.5	7.6	20.3	3,932	
Returned to RAC within 4 weeks 										
Re-admission into respite RAC	4.9	4.3	4.7		—	—	—	1.3	253	
Re-admission into permanent RAC	0.6	1.4	1.0		1.2	0.9	0.9	0.9	181	
Subtotal	5.5	5.7	5.6		1.2	0.9	0.9	2.2	434	
Total returners to the community	68.2	47.9	58.5		9.0	8.4	8.5	22.5	4,366	
Did not return to the community within 12 weeks										
In respite RAC after 12 weeks	20.1	26.8	23.3		—	—	—	6.5	1,264	
In permanent RAC after 12 weeks	0.5	1.6	1.0		82.9	68.6	70.9	51.3	9,953	
Discharged to hospital within 12 weeks	9.0	13.9	11.3		2.2	1.8	1.9	4.5	875	
Died in RAC within 12 weeks	2.2	9.8	5.8		5.9	21.2	18.8	15.1	2,937	
Total non-returners to the community 	31.8	52.1	41.5		91.0	91.6	91.5	77.5	15,029	
Total	100.0	100.0	100.0		100.0	100.0	100.0	100.0	. .	
Total (people)	2,851	2,576	5,427		2,218	11,750	13,968	. .	19,395	
Per cent of care type	56.2	18.0	. .		43.8	82.0	. .	. .	. .	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of initial RAC admission from hospital. 
3.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.
5.3	Survival of people admitted into permanent residential aged care
It is of interest to examine how long people survive once admitted to permanent care. The linked data provide the opportunity to estimate the time from entry into permanent RAC until death, taking into account whether they were admitted from hospital and, if so, the effect of various health conditions. For this study, this was done through a statistical technique called survival analysis which uses available variables to predict time to an event—in this case death following admission into permanent RAC. 
A useful characteristic of survival models is their ability to include censored observations in the analysis. Censored observations occur when the event is not observed during the period studied, so that a minimum survival time is known for the individual but the final survival time is not. A capacity to deal with censored data was needed for this analysis because not all deaths were recorded in the RAC data. For example, in 2001–02, 6% discharges from permanent RAC (excluding transfers) were for people reported as going to hospital and
4% were for people reported as going to live in the community (AIHW 2003c:56).
To perform the survival analysis, Cox proportional hazards regression models were fitted to the linked data. Cox proportional hazards regression models estimate the effect of explanatory variables on time to death by estimating their effect on the hazard ratio, also known as the relative risk (see Appendix F). The hazard ratio compares the risk of someone with a particular characteristic dying within the next time period with the risk of someone with a different (reference) characteristic. For example, if being male has a hazard ratio of 1.3, it means that men are 30% more likely to die in the next time period than women. 
One way to represent the results of survival analysis is by plotting the survival distribution function, which estimates the proportion of people who have not had the event (in this case, death) by a certain time. The average survival distribution function provides us with a population view of the survival times of people entering permanent RAC. This is estimated by fitting a hazard function to survival times without including any explanatory variables. 
Two Cox proportional hazards regression models were fitted for people entering permanent RAC:
•	Model C for all people moving into permanent RAC
•	Model D for people entering permanent RAC from hospital. 
Model C allows comparisons of survival times by whether the person was admitted from hospital or not. However, because data on health conditions were not available for people entering RAC from the community the effect of particular health conditions could not be examined via this model. Therefore, model D, which incorporates hospital-specific variables, was fitted to investigate the effect of health conditions on survival. In both cases, the models considered survival from the time of first admission into permanent RAC in the period of interest. Appendix F contains details of the models, including a complete list of variables used and results.
Date of death information came from ACCMIS and may not have been available (and therefore may have given rise to censored dates) for two reasons:
•	Death outside RAC: date of death is only available from the RAC data if the person died while in RAC. Therefore if the person died elsewhere we do not have their date of death, but have a date of their last discharge from RAC. This ‘last seen’ date is the censored date used in the survival analysis.
•	Currency of date of death data: in the data for this study date of death within RAC was only known for people who had died before 30 June 2004. People in RAC who had not died by 30 June 2004 were therefore known to have been alive on 30 June 2004. For these people, 30 June 2004 was used as the censored date.
People who were admitted into permanent RAC between 1 July 2001 and 31 December 2001 were included in the analysis. Admissions resulting from a transfer from respite RAC to permanent RAC were included as admissions into permanent care, while those arising from transfers from permanent care in one RAC facility to permanent care in another were not. 
5.3.1	All people entering permanent RAC
Overall, during 2001–02, there were an estimated 38,400 non-transfer admissions for people aged 65 and over into permanent RAC and 8,000 transfers from respite into permanent residential care (Table 1.3). During July–December 2001, a total of 23,089 people aged 65 years and over were identified as entering permanent RAC. Of these people 11,378 (49%) had a censored survival date as they had an unknown date of death. More than one-half (56%) of these people were known to be still living in RAC at the time of censoring (that is, were still in RAC on 30 June 2004), just over one-quarter (28%) had reportedly left to move to another RAC facility but were not subsequently identified as returning, 9% were recorded as returning to their home or family and 7% had been discharged to hospital. 
From the average survival distribution function (Figure 5.3), we see that one-quarter of all people entering permanent RAC between 1 July 2001 and 31 December 2001 died within just over 7 months (225 days) of admission and one-half died within 2 years and 2 months 
(774 days). Two-fifths of people in the analysis were still alive after 3 years.  

Figure 5.3:	Average survival function for people entering permanent RAC during 
July–December 2001
Line chart showing survival probability on y-axis and days until death since entering permanent RAC on x-axis.

Model C was fitted to identify factors associated with survival after entry into permanent care. Variables used in the model were sex, age at admission into RAC, marital status, state or territory of RAC admission, RCS category on admission (see Box 1.2), EP group, region of RAC facility, location of ACAT assessment, whether the person was admitted into RAC from hospital and whether the person had been in RAC before. Forward stepwise selection was used to enable identification of significant variables. Except for marital status, all of the variables were found to be significantly associated with survival time after admission into permanent RAC (Table F.1).
The effects of the variables included in the model can be seen by comparing estimated survival times following RAC admission. As with logistic regression, such comparisons are most easily understood with respect to a person with specific characteristics, or ‘reference’ person. Comparisons of survival times then relate to people with characteristics the same as those of the reference person except for the difference in the single variable whose effect is being considered. 
The reference person for this analysis is described in Box 5.3; again common characteristics were used. Model C estimates that the reference person—an 85 year old woman born in an English speaking country, in the highest care needs category, and admitted from the community for the first time into a facility in a major city in New South Wales after an ACAT assessment in hospital—had a 75% chance of surviving at least 4 months (121) days and 50% likelihood of surviving at least 14 months (425) days following admission into permanent RAC. These survival times are considerably shorter than those observed across all people entering permanent RAC (Figure 5.3). This is because the characteristics of the reference person overall result in a high relative risk of dying on any day. 

Box 5.3:		Reference person for comparison for survival analysis Model C (all persons to permanent RAC)
For this analysis the reference person has the following characteristics:
•	85 years old at admission
•	female
•	admitted to a RAC facility in New South Wales
•	admitted to a RAC facility in a major city
•	classified in RCS category 1—the highest care needs category—on admission
•	admitted to RAC from the community
•	first time in RAC
•	highest English proficiency level (Australian-born and EP1)
•	ACAT assessment in hospital.
These values were chosen because within each variable they were the most common among the people in the analysis. Marital status is not included as it did not contribute significantly to the model. Among people admitted to permanent RAC with these characteristics, Model C estimates that 75% survived at least 121 days and half survived at least 425 days.

The most significant variables for predicting survival time after RAC admission were RCS care needs category on admission, sex, age at RAC admission and whether the person was admitted into RAC from hospital.
As expected, having high care needs at the time of admission into permanent RAC were associated with an increased likelihood of death (Table F.1). Residents classified as RCS category 2 on admission were 22% less likely than residents classified as RCS category 1 to die on a given day (hazard ratio of 0.78), while RCS category 4 and category 5 residents were 56% and 66% less likely to die on a given day than RCS category 1 residents. Consequently, while it is estimated that the reference person—who is in RSC category 1—had a 25% chance of surviving at least 4 months (121 days) after admission, an adjusted reference person in RCS category 4 had a 25% chance of living at least 13 months (394 days). This estimated 75% survival time increased to 2 years and 7 months (944 days) for RCS category 7 (Figure 5.4a).
RAC residents who had a missing RCS category—particularly those who had received an ACAT approval for high-level care—were more likely to die than other residents (Table F.1). This finding reflects data collection practices: because RCS classifications may take several months to complete following admission into RAC, people with missing RCS categories are most likely those who died shortly after admission.
Men were 53% more likely than women to die on any day (Table F1, Figure 5.4c). For example, if the reference person were male, the model estimates that this person had a 50% chance of surviving 8 months (245 days) after admission into permanent RAC, compared with 14 months for the female reference person.
As would be expected, older age at admission into RAC was associated with an increased probability of death (Table F.1, Figure 5.4b). With each additional year of age, a person was 3% more likely to die on any given day. This equates to a 16% increase in the chance of dying with each 5 year increase in age. For example, in terms of survival times, an adjusted reference person admitted at age 65 had a 25% chance of surviving nearly 10 months (294 days) and 50% chance of surviving 2 years and 6 months (902 days) after admission. The comparable figures for someone admitted at age 95 were 11 weeks (76 days) and slightly under 10 months (290) days, respectively.
People admitted into RAC from hospital were 19% more likely to die on any day than those admitted from the community (Table F.1, Figure 5.4d). Thus, it is estimated that a person admitted from hospital had a 25% chance of dying within 3 months (92 days) after admission and 50% chance of dying within 11 months (342 days), compared with 4 months and 14 months, respectively, for the reference person admitted from the community.
Lower levels of English proficiency were associated with a lower probability of dying 
(Table F.1). People classified as being in EP groups 2, 3 and 4 were respectively 9%, 16% and 36% less likely to die on a given day than people born in Australia or another 
English-speaking country. Consequently, the estimated median survival time increased from 1 year and 2 months for the reference person (EP group 1) to 1 year and 4 months (490 days) for an adjusted reference person in EP group 2, and to 2 years and 3 months (761 days) for someone in EP group 4.
The location of a person’s ACAT assessment was associated with survival time following admission to permanent RAC (Table F.1). There was no difference in likelihood of death between people assessed in hospital and in permanent RAC. However, people assessed in their own home, or in another setting (including with missing location) were 10% and 16% less likely, respectively, to die on a given day than people who were assessed in hospital. For example, an adjusted reference person assessed at home had a 50% chance of surviving nearly 1 year and 5 months (503 days); the corresponding figure for someone assessed in another setting (but not in hospital) or with a missing place of assessment was 1 year and 6 months (551 days)—just over 4 months longer than the reference person assessed in hospital.
People who were admitted into a RAC facility in an inner or outer regional area had a higher probability of dying on any day than those admitted into a RAC facility in a major city (8% and 13% more, respectively) (Table F.1). For example, the median survival time is estimated at 1 year and 3 weeks (386 days) for an adjusted reference person admitted to an inner regional RAC facility, and 1 year (364 days) for someone admitted to an outer regional RAC facility. This pattern may reflect the observed movement of people from remote and very remote regions into RAC facilities in less remote regions (Section 4.4). A reluctance of people to move away from their region of usual residence is suggested by the relatively low likelihood of people from remoter areas to be discharged from hospital into permanent RAC (Section 5.1.2). Such reluctance could mean that people who need to change region when they enter permanent RAC delay the move compared with those who remain in their region of usual residence, leading to shorter survival times. This hypothesis is supported by the low hazard ratios for the remote and very remote categories of the variable indicating region of RAC facility.
Figure 5.4:	Survival functions for people entering permanent RAC during July–December 2001, 
by RCS category, sex, age and source of admission, controlling for all other variables
Four stacked line charts showing survival probability on y-axes and days until  death since entering permanent RAC on x-axes. The charts are (a) RCS category on admission; (b) Age at admission; (c) Sex; and (d) Source of RAC admission.
Note: Survival functions are based on reference person characteristics given in Box 5.3. Reference person is indicated by *.
5.3.2	People entering permanent RAC from hospital
An estimated 21,800 admissions into permanent RAC for people aged 65 and over were associated with discharge from hospital (Table 1.3). For the investigation into the association of particular health conditions with survival, a total of 13,185 people were identified as entering permanent RAC from hospital between 1 July and 31 December 2001. Of these people, 41% were either known to be alive at 30 June 2004 or had left RAC and not returned, and so had censored survival dates. Of the people with censored survival dates, nearly 
one-half (47%) were still living in RAC at the time of censoring, over one-quarter (29%) had been reported as going to another nursing home or hostel but had not been identified as subsequently re-entering RAC, while 7% had returned to their home or family and 7% had been discharged to hospital.
Overall, one-quarter of people admitted to permanent RAC from hospital between 1 July 2001 and 31 December 2001 died within 4 months (122 days) of entering RAC and a futher 25% died within the next 14 months (that is, within 542 days) (Figure 5.5). Less than one-third (31%) of people in the analysis were still alive after 3 years.

Figure 5.5:	Average survival function for people entering permanent RAC from hospital during July–December 2001
Line chart showing survival probability on y-axis and days until death since entering permanent RAC on x-axis.

Model D was fitted to identify factors associated with survival after entry into permanent care from hospital. Variables were entered into the model using a forward stepwise process. Explanatory variables included in the model were sex, age at RAC admission, marital status, EP group, state or territory of RAC admission, RCS category on admission, region of RAC facility, location of ACAT assessment, whether the person had been in RAC before, hospital sector (public/private), care type of hospital episode before discharge, length of hospital episode prior to discharge and a range of information on principal and additional diagnoses. Particular diagnoses were included in the modelling based on both their relevance to health priority areas and the number of people with the diagnosis (see Table C.1). Several of the variables were found to have no significant effect and were therefore excluded from the final model, including: marital status, EP group, location of ACAT assessment, whether the person had been in RAC before, hospital sector, number of hospital diagnoses and presence of certain medical conditions as an additional diagnosis (see Table F.2 for details of the final model). The state and territoriry and region variables also had no statistically significant effect but were included in the final model to control for variations in provision of RAC services.
A summary of the main results is below. The ‘reference’ person used to aid the discussion of this analysis is described in Box 5.4. The reference person for Model D is similar to that for Model C, with the addition of several hospital episode characteristics: the reference person was admitted from hospital after less than 1 week in acute care and had a principal diagnosis of stroke. Model D estimates that this reference person was more likely to die on any given day than the average person entering permanent RAC from hospital, having a 25% chance of dying within 3 months (95 days) and 50% chance of dying within a year (357 days) of admission into permanent RAC, compared with the population survival times of 4 and 18 months, respectively.

Box 5.4:	Reference person for comparison for survival analysis Model D (persons to permanent RAC from hospital)
For this analysis the reference person has the following characteristics:
•	85 years old at admission
•	female
•	admitted to a RAC facility in New South Wales
•	admitted to a RAC facility in a major city
•	classified in RCS category 1 on admission
•	hospital episode prior to admission to RAC was less than 1 week 
•	with a principal diagnosis of stroke
•	care type in hospital before discharge was acute care
•	no additional diagnoses in any of the 6 (out of 30 possible condition groups) found to have significant effects in the model (see Table F.2).
These values were chosen because within each variable either they were the reference category in the model or they were the most common for people in the analysis—except for principal diagnosis for which stroke was chosen because it is a readily understood diagnosis with sufficient numbers for parameter estimation. Variables not included in the final model are not specified. Among people admitted to permanent RAC from hospital with these characteristics, Model D estimates that 75% survived at least 95 days and half survived at least 357 days.

As with Model C, the most significant variable for predicting survival time for people admitted from hospital was RCS category on admission. However, the principal diagnosis while in hospital was also influential, with other significant variables being the presence of certain additional diagnoses, age at admission, sex, and hospital care type and length of hospital episode before discharge. 
While the effects of RCS category and age at admission were very similar to those seen for all people admitted to permanent care (Model C), the effect of sex was smaller. Men were 38% more likely to die on a given day than women (compared with 53% for Model C). Thus, while it is estimated that the reference person had a 50% likelihood of surviving almost 1 year after admission into RAC from hospital, an equivalent male had a 50% chance of dying within 8 months (231 days) (Table F.2, Figure 5.6a). 
Figure 5.6:	Survival functions for people entering permanent RAC from hospital during 
July–December 2001, by sex, length of hospital episode, hospital care type and additional hospital diagnoses, controlling for all other variables
Four stacked line charts showing survival probability on y-axes and days until death since entering permanent RAC on x-axes. The charts are: (a) Sex; (b) Length of hospital episode; (c) Hospital care type; and (d) Additional hospital diagnosis.
Note: Survival functions are based on reference person characteristics given in Box 5.4. Reference person is indicated by *, noting that the survival function by length of hospital episode is the same for all episodes under 8 weeks long. 

People with a principal diagnosis of neoplasm (cancer or tumour) had shorter survival times than others, with an adjusted reference person median survival time of just over 2 months 
(68 days) (Figure 5.7, Table 5.5). Only the uncommon principal diagnosis of cirrhosis and other diseases of the liver was associated with a similar probability of death. For other principal diagnoses, median survival times ranged from 4 months (120 days) for someone with chronic pulmonary obstructive disease (COPD) to just over 18 months (558 days) for someone with a principal diagnosis among mental and behavioural disorders excluding dementia (adjusted reference persons). 
In addition to the principal diagnosis, comorbidities, as indicated by additional diagnoses reported for the hospital episode, were also associated with likelihood of death (Table F.2, Figure 5.6d):
–	People with an additional diagnosis of neoplasm were more than twice as likely to die on any day as people without such a diagnosis.
–	People with an additional diagnosis of kidney disease, COPD or a disease of the artieries were 30%–50% more likely to die on any day than people without such a diagnosis.
–	Having an additional diagnosis among diseases of the nervous system was associated with an 18% decrease in the probability of death when compared with the absence of such a diagnosis.
Spending more than 8 weeks in hospital before being admitted into permanent RAC was associated with a decreased probability of dying (Table F.2, Figure 5.6b). Thus the estimated 50% survival time for an adjusted reference person who had an 8 to 12 week hospital episode before RAC admission was just over 15 months (470 days), compared with 1 year for the reference person who spent under 1 week in hospital before RAC admission. For hospital episodes longer than 12 weeks the median survival time following RAC admission was almost 17 months (514 days). Under 8 weeks, the length of the hospital episode before discharge to permanent RAC had no significant effect on likelihood of death. 
People who were in palliative care in hospital were much more likely to die on a given day than people who were in acute care in hospital (Table F.2, Figure 5.6c). An adjusted reference person in palliative care before entering RAC had a 25% chance of dying within 7 weeks 
(46 days) and 50% chance of dying within 6 months (170 days), compared with 3 months and 1 year, respectively, for our reference person in acute care before RAC admission.

Figure 5.7:	Survival functions for people entering permanent RAC from hospital during 
July–December 2001, by selected principal diagnoses, controlling for all other variables
Stacked line chart showing survival probability on y-axis and days until death since entering permanent RAC on x-axis. 
Note: Survival functions are based on reference person characteristics given in Box 5.4. Reference person is indicated by *.
Table 5.5:	Survival times for people entering RAC from hospital, by principal diagnosis (sorted by decreasing hazard ratio, derived using adjusted reference person)
Principal diagnosis	Estimated survival times(a)	
	75% still alive	50% still alive	25% still alive	
	Days	
Neoplasms (cancers and tumours) (reference)	23	68	201	
Diseases of the respiratory system: COPD	35	120	340	
Diseases of the digestive system: cirrhosis and other diseases of the liver	35	119	337	
Diseases of the genitourinary system: kidney failure	37	126	353	
Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)	50	190	496	
Endocrine, nutritional and metabolic diseases (excluding diabetes mellitus)	56	212	564	
Diseases of the respiratory system (excluding COPD and influenza and pneumonia)	59	228	597	
Diseases of the blood and blood-forming organs and immunological disorders	60	231	608	
Diseases of the circulatory system: ischaemic heart disease	62	239	623	
Endocrine, nutritional and metabolic diseases : diabetes mellitus	67	260	667	
Diseases of the respiratory system: influenza and pneumonia	69	270	692	
Diseases of the digestive system (excluding cirrhosis and other diseases of the liver)	72	279	709	
Infectious and parasitic diseases	82	323	803	
Diseases of the circulatory system: cerebrovascular disease (excl stroke)	84	328	811	
Diseases of the circulatory system: stroke 	95	357	888	
Diseases of the circulatory system: diseases of the arteries	95	357	888	
Symptoms, signs and abnormal findings n.e.c.	100	374	921	
Diseases of the musculoskeletal system and connective tissue 	102	383	936	
Diseases of the skin and subcutaneous tissue	105	387	946	
Factors influencing health status (excluding ‘Awaiting admission elsewhere)	111	403	976	
Diseases of the genitourinary system (excluding kidney failure)	112	407	985	
Other (including diseases of the ear and eye)/unknown	113	407	986	
Factors influencing health status: ‘Awaiting admission elsewhere’	115	416	1,009	
Injury, poisoning and other consequences of external causes (excluding injury caused by fall)	117	420	1,016	
Injury, poisoning and other consequences of external causes: injury caused by fall	123	446	1,058	
Mental and behavioural disorders: dementia and related disorders	129	464	1,078	
Diseases of the nervous system	147	522	>1,090	
Mental and behavioural disorders (excluding dementia and related disorders) 	158	558	>1,090	
(a)	Survival functions are based on reference person characteristics given in Box 5.4.

6	People with selected health conditions
In Section 3 it was seen that the prevalence of disease groups varied considerably with 
post-hospital destination, while the analyses in Section 5 showed that certain condition groups were associated with discharge to RAC and/or survival following admission to permanent RAC. In this section, outcomes for hospital patients with three conditions are examined in more detail: people in hospital with dementia, stroke, or as the result of injury due to a fall (Box 6.1). The first two conditions contribute significantly to the burden of disease among both men and women aged 75 (15% and 23%, respectively), while falls are significant particularly among older women (2% of burden of disease) (AIHW 2007b:65). In addition, unlike episodes of care for many other health conditions, in many cases hospitalisations for injury due to external causes may be avoidable through injury prevention practices (see also AIHW: Karmel et al. 2007b:16–18). 
Box 6.1:	Definition of selected diseases using ICD-10-AM Ed. 2 codes 
Dementia 	F00–F03, G30–G32 
Stroke			I60–I64
Injury from a fall	principal diagnosis S00–T98, with external cause W00–W19

In the following discussion it needs to be remembered that the diagnosis information available for hospital episodes relates to conditions that contribute to the complexity and cost of patient treatment (see Box 1.1). Consequently, a patient may have a health condition that was not reported for a specific hospital episode if it was not seen as affecting treatment. This is particularly relevant for people with dementia, so that the prevalence of dementia as a reported diagnosis is considerably less than the underlying prevalence in the patient population. 
For people returning to or entering permanent care from hospital we can compare the hospital diagnosis for dementia with a RAC dementia index (derived from RCS information) which has three categories of no dementia, possible dementia and probable dementia. Such comparisons show that many more people were classified in RAC as possibly or probably having dementia than had a diagnosis of dementia recorded in the hospital data (Table 6.1). Only 29% of transitions from hospital to permanent RAC had an associated hospital diagnosis of dementia whereas 50% of these transitions were for people identified as possibly having dementia using the RAC dementia index and 25% were for people who probably had dementia. For those without a hospital diagnosis of dementia about two-thirds (68%) were for people classified by the RAC index as possibly or probably having dementia. A small proportion of people (8%) who did not have dementia according to the RAC index had a hospital diagnosis of dementia.
Table 6.1:	Transitions from hospital into RAC for people aged 65+: hospital diagnosis of dementia compared with the RAC dementia index, 2001–02 (unadjusted)
	With any hospital dementia diagnosis		
RAC dementia index	No	Yes	Total	N	
	Row per cent		
No dementia	91.8	8.2	100.0	16,710	
Possible dementia	70.7	29.3	100.0	33,772	
Probable dementia	50.6	49.4	100.0	16,693	
All	71.0	29.0	100.0	. .	
	Column per cent		
No dementia	32.2	7.1	24.9	16,710	
Possible dementia	50.1	50.7	50.3	33,772	
Probable dementia	17.7	42.3	24.9	16,693	
Total	100.0	100.0	100.0	. .	
Total admissions/returns (number)	47,668	19,507	. .	67,175	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Table includes linked admissions into permanent RAC from hospital and returns to permanent RAC following a period in hospital. 
3.	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for a list of conditions included in ICD-10-AM chapters.
4.	RAC dementia index is derived from the Resident Classification Scale questions on communication (question 1) and understanding 
(question 8)—see AIHW 2004:Table 3.23 for derivation.
5.	Age is as at time of hospital admission.
6.1	Prevalence of selected conditions
Overall, among hospital episodes lasting at least one night and ending with the patient leaving hospital 6% had dementia reported among the diagnoses, 3% included a diagnosis of stroke and 4% had a principal diagnosis of injury caused by a fall (tables 6.2, 6.5 and 6.8). The prevalence of the three conditions was different in the various post-hospital destination groups, with the patterns across these groups varying with condition (Figure 6.1). However, all three were individually reported in 2%–3% of hospital episodes which ended with the patient returning to the community.
Dementia was most commonly reported among patients who were admitted to permanent RAC following their period in hospital (in 36% of separations), followed by 26% of those returning to permanent care and 22% of those moving to respite RAC (Table 6.2, Figure 6.1). 
A diagnosis of stroke was also most prevalent among people moving into permanent RAC (13%), but unlike the other two conditions, had a similarly high prevalence among deaths in hospital (Table 6.5). Injury caused by a fall as the principal diagnosis was most common among people returning to permanent RAC and people admitted to respite care following their hospital separation (10% and 9% of such transitions, p>0.05) (Table 6.8). Injury from a fall was a little less common as the principal diagnosis among people admitted into permanent RAC (7%). As expected, for all conditions prevalence was lowest among episodes ending with a return to the community (3% for both dementia and injury from a fall, and 2% for stroke). 
Figure 6.1:	Prevalence of selected health conditions by post-hospital destination
Vertical bar chart showing hospital separations on y-axis and post-hospital destination on x-axis. Key shows ‘with dementia (any)’, ‘with stroke (any)’ and ‘with injury and fall’.
Source: tables 6.2, 6.5 and 6.8.

Overall, dementia was more commonly recorded as a diagnosis in a hospital episode as age increased and more often for women than for men (Table 6.2). Similar patterns were evident for people in hospital as a result of injury caused by a fall (Table 6.8), but while age differences were apparent, the proportion of hospital episodes with a reported diagnosis of stroke was similar for men and women (Table 6.5). 
The patterns of prevalence of the selected conditions by age and sex differed noticeably across the post-hospital destination groups. Among people either returning or moving to permanent care from hospital, similar proportions of men and women had a hospital diagnosis of dementia (25% and 26% of transitions, respectively) (Table 6.2). In contrast, a slightly greater proportion of admissions to respite care for men were associated with a hospital diagnosis of dementia than those for women: 25% compared with 21% (p<0.01). Furthermore, while the prevalence of dementia increased with age both for hospital episodes ending with death or a return to the community, among transitions to RAC prevalence peaked in the 85–89 age group. 
The main difference observed between prevalence of stroke for men and women was among hospital episodes in which the patient died: stroke was reported as a diagnosis in 14% of hospital episodes in which women died compared with 10% for men, and this difference was seen for all age groups except the oldest (95+) where the difference was not statistically significant (Table 6.5). In contrast, men who moved to respite RAC were slightly more likely to have a diagnosis of stroke than women. As seen for dementia, the age pattern of prevalence of stroke was different for the various transition groups, with prevalence generally decreasing as age increased among people moving into permanent or respite residential care, but generally increasing with age among episodes ending in death or a return to the community.
As expected, there was a strong association between sex and age and being in hospital as the result of a fall (Table 6.8). For all transitions groups, the prevalence of a principal diagnosis of injury with an external cause of fall increased with age and was greater for women than for men.
6.2	Characteristics of people leaving hospital
The proportion of hospital separations (excluding deaths) associated with a transition to RAC was higher for older than for younger patients for all three health conditions (tables 6.3, 6.6 and 6.9). For people with a hospital diagnosis of dementia or stroke, in all age groups women were more likely than men to be discharged to RAC. However, among those in hospital because of a fall, this was the case only for people aged 80 and over.
For hospital separations with a diagnosis of dementia recorded, 58% of transitions to RAC were for people already in permanent care (Table 6.3), while for stroke the corresponding figure was just 31% (Table 6.6). On the other hand, a high proportion of hospital separations with stroke reported as a diagnosis and which were followed by admission into RAC were for permanent care, with permanent admissions being more than six times as common as admissions for respite care (Table 6.7). Dementia was less likely to be associated with a permanent admission (Table 6.4); however, permanent admissions were still four times more common than respite admissions where a diagnosis of dementia was reported for the hospital episode.
People who had been in hospital due to injury from a fall were more likely to be returning to RAC than people who had been in hospital because of other health conditions (tables 6.3, 6.6 and 6.9). In particular, 70% of transitions into RAC in which the principal diagnosis was injury resulting from a fall were for people already living in RAC, compared with 65% across all health conditions (Figure 6.2, Table 6.9). In addition, among admissions into RAC for this group, a relatively low proportion were for permanent care, with a permanent to respite care admission ratio of 2.0 to 1 (compared with an overall rate of 2.6 to 1—see Table 2.3). 
Among transitions to RAC where there was a diagnosis of dementia, the proportion relating to people already in permanent care increased with age, and consequently the proportion being admitted into permanent care decreased with increasing age (Table 6.3). In addition, the ratio of permanent to respite care admissions increased with age for people aged 75 and over (Table 6.4). These patterns were evident for both men and women.
Figure 6.2:	Movement into RAC from hospital
Vertical bar chart showing transitions into RAC on y-axis and selected health condition on x-axis. Key shows ‘returning to permanent RAC’, ‘to respite RAC’ and ‘to permanent RAC’.
Source: tables 3.4, 6.3, 6.6 and 6.9.

Women entering RAC from hospital with a diagnosis of stroke were more likely than men to be returning to care (34% versus 25%; Table 6.3). The likelihood of a transition to RAC being for a person who was already a permanent resident increased with age, and for people aged over 75, the ratio of permanent to respite admissions was also higher for older people (Table 6.4). However, for people with stroke, while the proportion of transitions associated with people returning to permanent care increased with age (Table 6.6), there did not seem to be a consistent association between age and the relative rate of permanent and respite care admissions (Table 6.7).
For men moving from hospital to RAC after a fall, increasing age did not seem to be consistently associated with the type of transition being made (Table 6.9). However, for women aged 75 years and older, as age increased the transitions were more likely to be a return to permanent care and less likely to be for respite care. As age increased, admissions were increasingly more likely to be for permanent care rather than respite care (Table 6.10).
Table 6.2:	Hospital separations for people aged 65+ with any diagnosis of dementia, by sex and movement type, 2001–02 (unadjusted)
Sex/age	Returning to perm-
anent RAC	To perm-anent RAC	To respite RAC	To comm-unity/
other	Died in hospital	All 		With dementia	All	
Men	Per cent with dementia		Number	
65–69	15.4	28.8	13.1	0.8	2.4	1.2		1,063	92,306	
70–74	23.0	29.1	21.2	1.5	4.7	2.3		2,517	109,564	
75–79	23.9	33.4	26.5	2.6	8.0	4.1		4,579	112,804	
80–84	27.3	38.6	27.8	4.5	12.4	7.2		5,826	80,936	
85–89	28.2	38.7	27.7	7.1	17.7	11.3		5,001	44,296	
90–94	25.0	38.2	23.6	9.5	18.5	14.6		2,095	14,363	
95+	22.8	30.6	18.0	8.8	22.9	15.3		400	2,609	
All	25.3	35.7	25.2	2.8	10.1	4.7		. .	. .	
With dementia (number)	3,876	2,718	684	11,475	2,728	. .		. .	. .	
Total separations (number)	15,346	7,621	2,718	404,223	26,970	. .		21,481	456,878	
Women										
65–69	15.6	24.9	8.1	0.7	2.5	1.0		772	75,568	
70–74	19.2	28.7	15.4	1.5	4.5	2.2		2,114	94,437	
75–79	24.4	35.7	19.5	3.2	8.1	4.9		5,499	111,145	
80–84	26.7	38.8	22.9	5.5	13.9	8.9		8,809	99,037	
85–89	28.2	39.1	22.6	8.4	18.4	13.7		9,828	71,994	
90–94	27.5	34.8	20.5	10.8	21.1	17.1		5,266	30,760	
95+	25.9	31.8	14.6	12.7	20.8	18.9		1,406	7,424	
All	26.3	36.3	20.6	3.9	12.7	6.9		. .	. .	
With dementia (number)	8,673	4,526	1,036	16,377	3,082	. .		. .	. .	
Total separations (number)	32,948	12,478	5,021	415,567	24,351	. .		33,694	490,365	
All										
65–69	15.5	27.0	10.7	0.8	2.5	1.1		1,835	167,874	
70–74	21.1	28.9	18.0	1.5	4.6	2.3		4,631	204,001	
75–79	24.2	34.6	22.4	2.9	8.1	4.5		10,078	223,949	
80–84	26.9	38.7	24.6	5.0	13.1	8.1		14,635	179,973	
85–89	28.2	38.9	24.1	7.9	18.0	12.8		14,829	116,290	
90–94	27.0	35.7	21.4	10.4	20.1	16.3		7,361	45,123	
95+	25.3	31.5	15.4	11.6	21.5	18.0		1,806	10,033	
All	26.0	36.0	22.2	3.4	11.3	5.8		. .	. .	
With dementia (number)	12,549	7,244	1,720	27,852	5,810	. .		. .	. .	
Total separations (number)	48,294	20,099	7,739	819,790	51,321	. .		55,175	947,243	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	878 records were excluded due to missing diagnosis information.
Table 6.3:	Summary of movements from hospital into RAC for people aged 65+ with any diagnosis of dementia, by movement type, Australia, 2001–02 (unadjusted)
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men with dementia	Row per cent		Est’d min %	Est’d max %	
65–69	49.1	43.1	7.9	100.0	267	27.2	30.2	
70–74	55.4	35.0	9.6	100.0	749	32.8	36.5	
75–79	49.5	38.8	11.7	100.0	1,394	34.3	38.1	
80–84	51.3	38.7	10.0	100.0	2,018	39.4	43.8	
85–89	55.3	36.3	8.4	100.0	1,821	43.0	47.9	
90–94	57.1	35.4	7.6	100.0	857	48.4	53.9	
95+	62.8	32.0	5.2	100.0	172	56.8	63.1	
All	53.3	37.3	9.4	100.0	. .	38.8	43.2	
Total separations (N)	 3,876 	2,718 	  684 	. .	7,278	18,753	
Women with dementia						 	 	
65–69	53.5	40.8	5.6	100.0	213	29.6	32.9	
70–74	51.6	38.8	9.6	100.0	649	32.9	36.6	
75–79	54.8	35.8	9.3	100.0	1,889	36.9	41.1	
80–84	57.2	33.8	9.0	100.0	3,607	44.7	49.7	
85–89	62.8	30.4	6.8	100.0	4,506	50.8	56.5	
90–94	67.4	27.6	5.0	100.0	2,630	56.5	62.8	
95+	70.6	26.5	3.0	100.0	741	61.0	67.9	
All	60.9	31.8	7.3	100.0	. .	46.5	51.7	
Total separations (N)	            8,673 	   4,526 	1,036 	. .	14,235	30,612	
All with dementia						 	 	
65–69	51.0	42.1	6.9	100.0	480	28.2	31.4	
70–74	53.6	36.8	9.6	100.0	1,398	32.9	36.6	
75–79	52.6	37.1	10.3	100.0	3,283	35.8	39.8	
80–84	55.1	35.5	9.4	100.0	5,625	42.7	47.5	
85–89	60.6	32.1	7.3	100.0	6,327	48.3	53.7	
90–94	64.8	29.5	5.6	100.0	3,487	54.3	60.4	
95+	69.1	27.5	3.4	100.0	913	60.2	66.9	
All	58.3	33.7	8.0	100.0	. .	43.6	48.5	
Total separations (number)	      12,549 	        7,244 	         1,720 	. .	21,513	49,365	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	67 records were excluded due to missing diagnosis information.
Table 6.4:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+ with any diagnosis of dementia, by movement type, Australia, 
2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men with dementia	Number (unadjusted hospital separations)	Ratio	
65–69	115	21	136	5.5	:	1	
70–74	262	72	334	3.6	:	1	
75–79	541	163	704	3.3	:	1	
80–84	781	201	982	3.9	:	1	
85–89	661	153	814	4.3	:	1	
90–94	303	65	368	4.7	:	1	
95+	55	9	64	6.1	:	1	
All	2,718	684	3,402	4.0	:	1	
Women with dementia							
65–69	87	12	99	7.3	:	1	
70–74	252	62	314	4.1	:	1	
75–79	677	176	853	3.8	:	1	
80–84	1,218	325	1,543	3.7	:	1	
85–89	1,369	308	1,677	4.8	:	1	
90–94	727	131	858	5.5	:	1	
95+	196	22	218	8.9	:	1	
All	4,526	1,036	5,562	4.4	:	1	
All with dementia							
65–69	202	33	235	6.1	:	1	
70–74	514	134	648	3.8	:	1	
75–79	1,218	339	1,557	3.6	:	1	
80–84	1,999	526	2,525	3.8	:	1	
85–89	2,030	461	2,491	4.4	:	1	
90–94	1,030	196	1,226	5.3	:	1	
95+	251	31	282	8.1	:	1	
All	7,244	1,720	8,964	4.2	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	67 records were excluded due to missing diagnosis information.
Table 6.5:	Hospital separations for people aged 65+ with any diagnosis of stroke, by sex and movement type, 2001–02 (unadjusted)
Sex/Age	Returning to perm-
anent RAC	To perm-anent RAC	To respite RAC	To comm-unity/
other	Died in hospital	All 		With stroke	All	
Men	Per cent with stroke		Number	
65–69	1.5	16.8	8.1	1.6	8.9	1.9		1,796	92,306	
70–74	2.6	15.5	8.2	1.8	9.0	2.3		2,530	109,564	
75–79	3.0	13.5	6.0	2.0	9.9	2.6		2,967	112,804	
80–84	2.5	12.5	6.6	2.3	10.9	3.2		2,577	80,936	
85–89	2.1	12.1	4.3	2.3	12.2	3.7		1,639	44,296	
90–94	2.6	9.0	4.7	2.2	11.8	3.9		558	14,363	
95+	1.5	8.3	n.p.	1.6	11.6	3.7		96	2,609	
All	2.4	12.7	6.1	1.9	10.3	2.7		 . .	 . .	
With stroke (number)	373	969	165	7,865	2,791	 . .		 . .	 . .	
Total separations (number)	15,346	7,621	2,718	404,223	26,970	 . .		12,163	456,878
	
Women										
65–69	3.3	14.9	n.p.	1.1	8.6	1.4		1,078	75,568	
70–74	2.7	14.7	5.2	1.4	10.4	1.9		1,774	94,437	
75–79	2.9	14.1	4.9	1.8	13.0	2.6		2,851	111,145	
80–84	2.9	13.5	5.1	2.1	15.1	3.2		3,204	99,037	
85–89	2.9	11.9	4.8	2.3	16.5	3.9		2,812	71,994	
90–94	2.6	10.0	2.7	2.0	17.4	4.1		1,275	30,760	
95+	2.4	7.0	4.0	2.0	13.7	4.0		298	7,424	
All	2.8	12.4	4.6	1.7	14.1	2.7		 . .	 . .	
With stroke (number)	919	1,542	230	7,179	3,422	 . .		 . .	 . .	
Total separations (number)	32,948	12,478	5,021	415,567	24,351	 . .		13,292	490,365
	
All										
65–69	2.3	15.9	5.5	1.4	8.8	1.7		2,874	167,874	
70–74	2.6	15.1	6.6	1.6	9.5	2.1		4,304	204,001	
75–79	2.9	13.8	5.3	1.9	11.2	2.6		5,818	223,949	
80–84	2.7	13.1	5.6	2.2	13.0	3.2		5,781	179,973	
85–89	2.7	12.0	4.7	2.3	14.6	3.8		4,451	116,290	
90–94	2.6	9.7	3.3	2.1	15.3	4.1		1,833	45,123	
95+	2.2	7.3	4.0	1.9	13.0	3.9		394	10,033	
All	2.7	12.5	5.1	1.8	12.1	2.7		 . .	 . .	
With stroke (number)	1,292	2,511	395	15,044	6,213	 . .		 . .	 . .	
Total separations (number)	48,294	20,099	7,739	819,790	51,321	 . .		25,455	947,243
	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	878 records were excluded due to missing diagnosis information.
Table 6.6:	Summary of movements from hospital into RAC for people aged 65+ with any diagnosis of stroke, by movement type, Australia, 2001–02 
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men with stroke	Row per cent		Est’d min %	Est’d max %	
65–69	14.0	>64.5	<21.5	100.0	93	6.2	6.9	
70–74	22.0	65.0	13.1	100.0	214	10.3	11.5	
75–79	25.7	63.6	10.8	100.0	343	14.7	16.3	
80–84	23.7	64.1	12.2	100.0	393	20.1	22.4	
85–89	24.5	67.6	7.8	100.0	306	27.6	30.7	
90–94	37.3	53.0	9.7	100.0	134	38.4	42.7	
95+	29.2	>50.0	<20.8	100.0	24	51.1	56.8	
All	24.8	64.3	10.9	100.0	. .	16.1	17.9	
Total separations (N)	               373 	               969 	                165 	. .	 1,507 	9,372	
Women with stroke								
65–69	30.0	>63.8	<6.3	100.0	80	8.9	9.9	
70–74	23.9	65.5	10.7	100.0	197	13.7	15.2	
75–79	28.1	61.8	10.1	100.0	434	19.4	21.6	
80–84	31.2	58.8	10.0	100.0	719	30.0	33.4	
85–89	37.4	54.1	8.6	100.0	771	39.5	44.0	
90–94	42.2	53.4	4.3	100.0	393	50.8	56.5	
95+	49.5	>40.2	<10.3	100.0	97	56.4	62.7	
All	34.2	57.3	8.5	100.0	. .	27.3	30.3	
Total separations (N) (number)	               919 	            1,542 	                230 	. .	2,691	9,870	
All with stroke								
65–69	21.4	68.8	9.8	100.0	173	7.2	8.0	
70–74	22.9	65.2	11.9	100.0	411	11.7	13.0	
75–79	27.0	62.5	10.4	100.0	777	17.0	18.9	
80–84	28.5	60.7	10.8	100.0	1,112	25.6	28.5	
85–89	33.7	57.9	8.4	100.0	1,077	35.2	39.2	
90–94	41.0	53.3	5.7	100.0	527	46.9	52.2	
95+	45.5	47.9	6.6	100.0	121	55.3	61.5	
All	30.8	59.8	9.4	100.0	. .	21.8	24.3	
Total separations (number)	       1,292 	        2,511 	           395 	. .	4,198	19,242	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	67 records were excluded due to missing diagnosis information.
Table 6.7:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+ with any diagnosis of stroke, by movement type, Australia, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men with stroke	Number (unadjusted hospital separations)	Ratio	
65–69	>60	<20	80	n.p.	:	1	
70–74	139	28	167	5.0	:	1	
75–79	218	37	255	5.9	:	1	
80–84	252	48	300	5.3	:	1	
85–89	207	24	231	8.6	:	1	
90–94	71	13	84	5.5	:	1	
95+	>12	<5	17	n.p.	:	1	
All	969	165	1,134	5.9	:	1	
Women with stroke							
65–69	>51	<5	56	n.p.	:	1	
70–74	129	21	150	6.1	:	1	
75–79	268	44	312	6.1	:	1	
80–84	423	72	495	5.9	:	1	
85–89	417	66	483	6.3	:	1	
90–94	210	17	227	12.4	:	1	
95+	>39	<10	49	n.p.	:	1	
All	1,542	230	1,772	6.7	:	1	
All with stroke							
65–69	119	17	136	7.0	:	1	
70–74	268	49	317	5.5	:	1	
75–79	486	81	567	6.0	:	1	
80–84	675	120	795	5.6	:	1	
85–89	624	90	714	6.9	:	1	
90–94	281	30	311	9.4	:	1	
95+	58	8	66	7.3	:	1	
All	2,511	395	2,906	6.4	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	67 records were excluded due to missing diagnosis information.

Table 6.8:	Hospital separations for people aged 65+ with principal diagnosis of injury and external cause of fall, by sex and movement type, 2001–02 (unadjusted)
Sex/Age	Returning to perm-
anent RAC	To perm-anent RAC	To respite RAC	To comm-unity/
other	Died in hospital	All 		With injury caused by fall	All	
Men	Per cent with injury caused by fall		Number	
65–69	4.6	2.8	3.8	1.5	1.1	1.5		1,386	92,306	
70–74	5.5	2.4	4.7	1.4	1.1	1.5		1,637	109,564	
75–79	5.6	4.0	4.7	1.6	2.1	1.8		2,021	112,804	
80–84	6.0	3.8	5.0	2.2	2.8	2.5		1,996	80,936	
85–89	7.7	5.5	5.8	3.1	4.4	3.7		1,635	44,296	
90–94	8.5	6.8	8.7	4.4	6.2	5.4		776	14,363	
95+	10.8	7.8	n.p.	6.2	10.6	7.9		206	2,609	
Total	6.6	4.4	5.4	1.8	2.7	2.1		 . .	 . .	
With injury caused by fall (number)	1,019	337	147	7,422	732	 . .		 . .	 . .	
Total separations (number)	15,346	7,621	2,718	404,223	26,970	 . .		9,657	456,878
	
Women										
65–69	7.5	4.3	6.1	2.8	0.9	2.8		2,090	75,568	
70–74	8.0	5.1	6.9	3.3	1.8	3.3		3,147	94,437	
75–79	9.2	5.1	10.3	4.0	2.6	4.2		4,674	111,145	
80–84	10.9	8.2	10.8	5.3	4.9	5.9		5,836	99,037	
85–89	12.1	9.9	10.7	6.7	6.4	7.6		5,503	71,994	
90–94	13.6	10.8	13.3	9.0	8.3	10.1		3,107	30,760	
95+	16.9	11.5	16.6	11.3	11.8	13.0		966	7,424	
Total	11.7	8.4	10.7	4.5	4.7	5.2		 . .	 . .	
With injury caused by fall (number)	3,862	1,054	539	18,725	1,143	 . .		 . .	 . .	
Total separations (number)	32,948	12,478	5,021	415,567	24,351	 . .		25,323	490,365
	
All										
65–69	5.9	3.5	4.9	2.1	1.0	2.1		3,476	167,874	
70–74	6.7	3.8	5.9	2.3	1.4	2.3		4,784	204,001	
75–79	7.8	4.6	8.0	2.8	2.3	3.0		6,695	223,949	
80–84	9.3	6.5	8.8	3.9	3.8	4.4		7,832	179,973	
85–89	11.0	8.4	9.3	5.2	5.5	6.1		7,138	116,290	
90–94	12.4	9.7	11.9	7.4	7.5	8.6		3,883	45,123	
95+	15.7	10.7	14.4	9.9	11.5	11.7		1,172	10,033	
Total	10.1	6.9	8.9	3.2	3.7	3.7		 . .	 . .	
With injury caused by fall (number)	4,881	1,391	686	26,147	1,875	 . .		 . .	 . .	
Total separations (number)	48,294	20,099	7,739	819,790	51,321	 . .		34,980	947,243	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	878 records were excluded due to missing diagnosis information.
Table 6.9:	Summary of movements from hospital into RAC for people aged 65+ with principal diagnosis of injury and external cause of fall, by movement type, Australia, 2001–02
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men with injury and fall	Row per cent		Est’d min %	Est’d max %	
65–69	69.6	>16.1	<14.3	100.0	56	4.2	4.6	
70–74	72.3	16.1	11.7	100.0	137	8.7	9.6	
75–79	63.3	25.4	11.3	100.0	256	13.6	15.1	
80–84	66.9	22.6	10.6	100.0	341	18.6	20.7	
85–89	68.5	23.5	8.0	100.0	400	27.7	30.8	
90–94	68.0	22.1	9.8	100.0	244	36.6	40.7	
95+	73.9	>18.8	<7.2	100.0	69	42.9	47.7	
All	67.8	22.4	9.8	100.0	. .	16.8	18.7	
Total separations (number)	            1,019 	               337 	         147 	. .	1,503	8,925	
Women with injury and fall								
65–69	69.6	>17.7	<12.7	100.0	79	3.8	4.2	
70–74	65.6	21.2	13.2	100.0	212	6.9	7.6	
75–79	67.5	16.5	16.0	100.0	581	12.8	14.2	
80–84	67.4	20.4	12.2	100.0	1,254	22.5	25.0	
85–89	71.2	20.2	8.5	100.0	1,709	33.1	36.8	
90–94	73.8	19.0	7.2	100.0	1,183	41.3	45.9	
95+	78.0	>15.1	<6.9	100.0	437	51.0	56.7	
All	70.8	19.3	9.9	100.0	. .	22.6	25.1	
Total separations (number)	            3,862 	            1,054 	            539 	. .	5,455	24,180	
All with injury and fall								
65–69	69.6	19.3	11.1	100.0	135	3.9	4.4	
70–74	68.2	19.2	12.6	100.0	349	7.5	8.3	
75–79	66.2	19.2	14.6	100.0	837	13.0	14.5	
80–84	67.3	20.9	11.8	100.0	1,595	21.5	23.9	
85–89	70.7	20.9	8.4	100.0	2,109	31.9	35.5	
90–94	72.8	19.6	7.6	100.0	1,427	40.4	44.9	
95+	77.5	16.8	5.7	100.0	506	49.7	55.3	
All	70.1	20.0	9.9	100.0	. .	21.0	23.4	
Total separations (number)	       4,881 	        1,391 	           686 	. .	6,958	33,105	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	67 records were excluded due to missing diagnosis information.
Table 6.10:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+ with any diagnosis of injury and external cause of fall, by movement type, Australia, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men with injury and fall	Number (unadjusted hospital separations)	Ratio	
65–69	>9	<8	17	n.p.	:	1	
70–74	22	16	38	1.4	:	1	
75–79	65	29	94	2.2	:	1	
80–84	77	36	113	2.1	:	1	
85–89	94	32	126	2.9	:	1	
90–94	54	24	78	2.3	:	1	
95+	>13	<5	18	n.p.	:	1	
All	337	147	484	2.3	:	1	
Women with injury and fall							
65–69	>14	<10	24	n.p.	:	1	
70–74	45	28	73	1.6	:	1	
75–79	96	93	189	1.0	:	1	
80–84	256	153	409	1.7	:	1	
85–89	346	146	492	2.4	:	1	
90–94	225	85	310	2.6	:	1	
95+	>66	<30	96	n.p.	:	1	
All	1,054	539	1,593	2.0	:	1	
All with injury and fall							
65–69	26	15	41	1.7	:	1	
70–74	67	44	111	1.5	:	1	
75–79	161	122	283	1.3	:	1	
80–84	333	189	522	1.8	:	1	
85–89	440	178	618	2.5	:	1	
90–94	279	109	388	2.6	:	1	
95+	85	29	114	2.9	:	1	
All	1,391	686	2,077	2.0	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	67 records were excluded due to missing diagnosis information.
6.3	Hospital care characteristics 
Overall, exiting hospital episodes with a recorded diagnosis of stroke or dementia were less likely than others to have been for acute care (71% and 81% of separations for all such hospital episodes, respectively, compared with the average of 91%). This was true irrespective of movement type. On the other hand, those episodes with a principal diagnosis of injury from a fall were highly likely to have been for acute care (over 85% for all movement groups, and 98% overall) (Figure 6.3, tables 6.11, 6.12 and 6.13). 
Figure 6.3:	Relative use of acute care for selected health conditions, by post-hospital destination
Four vertical bar charts showing hospital separations (% in acute care) on y-axes and post-hospital destinations on x-axes. The charts are with dementia (any); with stroke (any); with injury and fall; and all separations.
Source: tables 3.12, 6.11, 6.12 and 6.13.

Generally, people with a diagnosis of dementia were more likely to be receiving maintenance care before discharge from hospital (7%) than people without this diagnosis (1%) (Table 6.11). Among transition groups, the difference in patterns of care type between people with and without dementia was greatest among the group of people returning to the community. For this group 83% of people with dementia were discharged from acute care compared with 93% of those without dementia. 
People with stroke were less likely to be in acute care prior to leaving hospital and more likely to be in rehabilitation than others, whether they moved to RAC or to the community 
(Table 6.12). The largest differences were for those who moved to respite care (54% with stroke were in acute care compared to 74% of those without a diagnosis of stroke) or back to the community (66% compared with 94%). 
For all transition groups, people with a diagnosis of injury due to a fall were more likely to be receiving acute care prior to leaving hospital and less likely to be in rehabilitation, with the largest differences observed among those entering RAC (Table 6.13). For those moving into permanent RAC, 85% of those in hospital due to a fall were discharged from acute care compared with 49% in hospital for other reasons. For those moving into respite care the corresponding figures were 96% and 71%. 
For people who died in hospital, those with a diagnosis of dementia or who had a principal diagnosis of injury as a result of a fall were less likely to be receiving palliative care than other people (9% compared with 18% and 2% compared with 17%, respectively).
People moving to RAC following a period in hospital with any of the three conditions under consideration had relatively high care needs once in RAC (Table 6.14). The largest difference was for dementia with 79% of people with a hospital diagnosis of dementia being high care compared with 54% of people without such a diagnosis. The comparative proportions for diagnoses of stroke and fall were 79% versus 60%, and 74% versus 60%, respectively. 
For each condition the smallest difference in care needs was for people admitted into RAC for permanent care. For example, 87% of admissions for those with a diagnosis of dementia were for high care compared with 80% of admissions for people without. In comparison, when dementia was recorded as a diagnosis in hospital, high care was needed for 56% of respite admissions while among similar transitions without such a diagnosis 39% of admissions were for high care. Although the differences were not as large, similar patterns were seen for people with a hospital diagnosis of stroke or in hospital because of a fall. The highest differences in care needs were for people returning to RAC from hospital leave with a diagnosis of dementia or who were in hospital because of a fall. For dementia, 77% of people returning to RAC with a diagnosis of dementia were high care compared with 48% without this diagnosis; for injury the comparable proportions were 73% and 53%.
Table 6.11:	Hospital separations for people aged 65+, by any diagnosis of dementia, movement type and hospital care type, 2001–02 (unadjusted)
Sex/hospital care type	Return-ing to perm-anent RAC	To perm-anent RAC	To respite RAC	To comm-unity/
other	Died in hospital	All		All	
With dementia	Per cent 		Number	
Acute	93.3	52.2	73.6	83.1	79.0	80.6		44,363	
Rehabilitation	3.3	7.7	7.9	7.2	1.7	5.8		3,214	
Palliative	0.2	0.6	0.3	0.5	8.8	1.3		728	
GEM	1.2	8.8	2.6	3.0	2.1	3.2		1,779	
Psychogeriatric	1.0	2.1	1.5	1.1	0.7	1.2		668	
Maintenance	0.8	23.4	13.1	4.4	6.6	6.6		3,627	
Other	0.1	5.1	1.0	0.7	1.1	1.2		649	
Total	100.0	100.0	100.0	100.0	100.0	100.0		. .	
Total separations (N)	12,525	7,233	1,719	27,741	5,810	. .		55,028	
Without dementia									
Acute	92.7	50.4	73.3	93.4	77.4	91.8		814,567	
Rehabilitation	4.9	12.1	14.0	4.5	1.1	4.5		39,907	
Palliative	0.4	2.6	1.1	0.5	17.9	1.5		12,950	
GEM	1.1	8.0	1.8	0.7	1.1	0.8		7,229	
Psychogeriatric	0.3	0.2	0.4	0.1	—	0.1		771	
Maintenance	0.5	20.6	8.3	0.5	2.0	0.9		8,377	
Other	0.1	6.1	1.0	0.3	0.4	0.4		3,224	
Total	100.0	100.0	100.0	100.0	100.0	100.0		. .	
Total separations (N)	35,627	12,831	6,014	787,003	45,550	. .		887,025	
All 	Per cent with dementia			
Acute	26.1	36.9	22.3	3.0	11.5	5.2		858,930	
Rehabilitation	19.2	26.5	13.8	5.4	15.8	7.5		43,121	
Palliative	17.5	12.1	8.1	3.1	5.9	5.3		13,678	
GEM	26.5	38.2	29.8	13.8	19.2	19.7		9,008	
Psychogeriatric	57.5	82.8	48.1	34.4	76.8	46.4		1,439	
Maintenance	36.0	39.1	30.9	22.8	29.5	30.2		12,004	
Other	33.3	32.0	23.7	7.9	24.4	16.8		3,873	
All 	26.0	36.0	22.2	3.4	11.3	5.8		. .	
With dementia (number)	12,525	7,233	1,719	27,741	5,810	. .		. .	
Total separations (number)	48,152	20,064	7,733	814,744	51,360	. .		942,053	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	Newborn care types, organ procurement and hospital boarders were excluded from the tables (1 case).
5.	6,107 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
Table 6.12:	Hospital separations for people aged 65+, by any diagnosis of stroke, movement type and hospital care type, 2001–02 (unadjusted)
Sex/hospital care type	Return-ing to perm-anent RAC	To perm-anent RAC	To respite RAC	To comm-unity/
other	Died in hospital	All		All	
With stroke	Per cent 		Number	
Acute	83.6	49.2	53.7	66.3	87.5	70.5		17,864	
Rehabilitation	12.3	16.5	30.9	29.2	1.9	20.5		5,185	
Palliative	0.5	0.5	0.3	0.2	6.1	1.7		429	
GEM	2.1	6.4	2.3	2.3	1.0	2.4		605	
Psychogeriatric	0.3	—	—	0.1	0.1	0.1		19	
Maintenance	1.2	20.9	11.1	1.4	2.6	3.8		959	
Other	0.1	6.4	1.8	0.5	0.7	1.1		287	
Total	100.0	100.0	100.0	100.0	100.0	100.0		. .	
Total separations (N)	1,288	2,502	395	14,951	6,212	. .		25,348	
Without stroke									
Acute	93.1	51.3	74.4	93.6	76.2	91.7		841,066	
Rehabilitation	4.3	9.6	11.7	4.1	1.1	4.1		37,936	
Palliative	0.4	2.1	1.0	0.5	18.4	1.4		13,249	
GEM	1.1	8.6	1.9	0.7	1.2	0.9		8,403	
Psychogeriatric	0.5	1.1	0.7	0.1	0.1	0.2		1,420	
Maintenance	0.6	21.7	9.3	0.6	2.5	1.2		11,045	
Other	0.1	5.7	0.9	0.3	0.5	0.4		3,586	
Total	100.0	100.0	100.0	100.0	100.0	100.0		. .	
Total separations (N)	46,864	17,562	7,338	799,793	45,148	. .		916,705	
All 	Per cent with stroke			
Acute	2.4	12.0	3.7	1.3	13.6	2.1		858,930	
Rehabilitation	7.2	19.6	12.5	11.7	19.8	12.0		43,121	
Palliative	3.5	3.2	1.4	0.7	4.4	3.1		13,678	
GEM	4.9	9.6	6.0	5.8	9.9	6.7		9,008	
Psychogeriatric	1.8	0.5	—	0.9	10.7	1.3		1,439	
Maintenance	5.3	12.1	6.1	4.0	12.5	8.0		12,004	
Other	2.4	13.9	9.2	3.1	17.7	7.4		3,873	
All 	2.7	12.5	5.1	1.8	12.1	2.7		. .	
With stroke (number)	1,288	2,502	395	14,951	6,212	. .		. .	
Total separations (number)	48,152	20,064	7,733	814,744	51,360	. .		942,053	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	Newborn care types, organ procurement and hospital boarders were excluded from the tables (1 case).
5.	6,107 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
Table 6.13:	Hospital separations for people aged 65+, by principal diagnosis of injury caused by fall, movement type and hospital care type, 2001–02 (unadjusted)
Sex/hospital care type	Return-ing to perm-anent RAC	To perm-anent RAC	To respite RAC	To comm-unity/
other	Died in hospital	All		All	
With injury and fall	Per cent 		Number	
Acute	98.4	84.7	95.5	98.3	95.7	97.6		33,956	
Rehabilitation	0.1	0.3	0.3	0.1	0.1	0.1		47	
Palliative	0.1	0.1	0.1	0.1	2.3	0.2		62	
GEM	1.2	8.4	2.2	1.2	1.2	1.5		528	
Psychogeriatric	0.0	0.1	—	—	—	—		5	
Maintenance	0.1	4.2	1.7	0.2	0.4	0.4		141	
Other	0.0	2.2	0.1	0.1	0.2	0.2		68	
Total	100.0	100.0	100.0	100.0	100.0	100.0		. .	
Total separations (N)	4,870	1,390	686	25,986	1,875	. .		34,807	
Without injury and fall									
Acute	92.2	48.5	71.2	92.9	76.9	90.9		824,974	
Rehabilitation	5.0	11.3	13.8	4.7	1.2	4.7		43,074	
Palliative	0.4	2.0	1.0	0.6	17.4	1.5		13,616	
GEM	1.1	8.3	1.9	0.7	1.2	0.9		8,480	
Psychogeriatric	0.5	1.0	0.7	0.1	0.1	0.2		1,434	
Maintenance	0.6	22.9	10.1	0.7	2.6	1.3		11,863	
Other	0.1	6.0	1.1	0.3	0.5	0.4		3,805	
Total	100.0	100.0	100.0	100.0	100.0	100.0		. .	
Total separations (N)	43,282	18,674	7,047	788,758	49,485	. .		907,246	
All 	Per cent with injury and fall			
Acute	10.7	11.5	11.5	3.4	4.5	4.0		858,930	
Rehabilitation	0.2	0.2	0.2	0.1	0.3	0.1		43,121	
Palliative	1.8	0.3	1.4	0.3	0.5	0.5		13,678	
GEM	10.7	7.0	9.9	5.2	3.7	5.9		9,008	
Psychogeriatric	0.9	0.5	—	0.2	—	0.3		1,439	
Maintenance	2.1	1.4	1.7	1.0	0.6	1.2		12,004	
Other	2.4	2.7	1.3	1.4	1.2	1.8		3,873	
All 	10.1	6.9	8.9	3.2	3.7	3.7		. .	
With injury and fall (number)	4,870	1,390	686	25,986	1,875	. .		. .	
Total separations (number)	48,152	20,064	7,733	814,744	51,360	. .		942,053	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
4.	Newborn care types, organ procurement and hospital boarders were excluded from the tables (1 case).
5.	6,107 records with unknown care type were excluded from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
Table 6.14:	People aged 65+ entering RAC from hospital, by hospital diagnosis, movement type and RCS care level, 2001–02 (unadjusted)
Hospital diagnosis	Returning from hospital leave	To permanent RAC from hospital	To respite RAC from hospital	All	
Any dementia					
With dementia: per cent high care 	77.4	87.1	55.8	78.9	
Without dementia: per cent high care 	47.6	80.1	39.1	54.3	
All with dementia (number)	12,549	7,244	1,720	21,513	
All without dementia (number)	35,770	12,873	6,022	54,665	
Any stroke	 	 	 	 	
With stroke: per cent high care 	66.6	89.7	54.7	79.3	
Without stroke: per cent high care 	55.0	81.6	42.2	60.2	
All with stroke (number)	1,292	2,511	395	4,198	
All without stroke (number)	47,027	17,606	7,347	71,980	
Principal diagnosis of Injury and fall	 	 	 	 	
With injury and fall: per cent high care 	73.4	87.0	49.7	73.8	
Without injury and fall: per cent high care 	53.3	82.3	42.2	60.0	
All with injury and fall (number)	4,881	1,391	686	6,958	
All without injury and fall (number)	43,438	18,726	7,056	69,220	
All	 	 	 	 	
Per cent high care	55.3	82.6	42.8	61.2	
Total (number)	48,319	20,117	7,742	76,178	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of RAC admission.
4.	One record was excluded due to missing RCS care level.

6.4	Length of stay in hospital
Of the three conditions being examined, the presence of stroke had the greatest effect on length of stay in hospital (Figure 6.4). Excluding hospital episodes ending in death, episodes for people with a diagnosis of stroke were on average 4 to 10 days longer than those for people without such a diagnosis, depending on movement type. The greatest difference in median length of stay was seen for people moving to residential respite care: those with a diagnosis of stroke had a median length of hospital episode of 25 days compared with a median of 14 days for those without such a diagnosis (Table 6.16).
For people returning to permanent care, average length of stay was the same whether or not a diagnosis of dementia was recorded for the hospital episode (median of 6 days for both men and women and nearly all age groups) (Table 6.15). Whether or not the hospitalisation of the RAC resident was caused by a fall also did not affect the median length of stay (Table 6.17). However, for other transition groups both these conditions were associated with slightly longer average stays. While length of stay varied with age and post-hospital destination (as seen earlier in Section 3.2), of the three conditions examined, only injury from a fall seemed to be associated with different patterns across the age groups.
Figure 6.4:	Median length of stay for selected health conditions, by post-hospital destination
Four vertical bar charts showing median length of stay (days) on y-axes and post-hospital destination on x-axes. The charts are with dementia (any); with stroke (any); with fall and injury; and all separations.
  Source: tables 6.15, 6.16 and 6.17.
Table 6.15:	Hospital separations for people aged 65+: median length of stay in hospital, by any dementia diagnosis, age and movement type, 2001–02 (unadjusted)
Dementia diagnosis/age	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	To community/
other	Died in hospital	All	
With dementia	Median (days)	
65–69	6	28	10	8	10	9	
70–74	6	29	17	7	9	8	
75–79	6	25	14	7	9	8	
80–84	6	25	16	7	8	8	
85–89	6	24	14	7	8	8	
90–94	6	22	15	7	8	8	
95+	5	23	11	6	8	7	
All with dementia	6	25	14	7	8	8	
Without dementia	 	 	 	 	 	 	
65–69	6	26	14	3	7	4	
70–74	6	23	13	4	7	4	
75–79	6	25	15	4	7	4	
80–84	6	23	14	5	8	5	
85–89	6	23	13.5	5	7	6	
90–94	6	22	13	5	7	6	
95+	6	21	15	5	7	6	
All without dementia	6	23	14	4	7	4	
All	 	 	 	 	 	 	
65–69	6	26	14	3	7	4	
70–74	6	25	14	4	7	4	
75–79	6	25	14	4	8	5	
80–84	6	24	14	5	8	5	
85–89	6	23	14	5	7	6	
90–94	6	22	13	6	7	6	
95+	5	21	14	6	7	6	
All separations	6	24	14	4	7	5	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.

Table 6.16:	Hospital separations for people aged 65+: median length of stay in hospital, by any stroke diagnosis, age and movement type, 2001–02 (unadjusted)
Stroke diagnosis/age	Returning to permanent RAC	To permanent RAC	To 
respite
 RAC	To community/
other	Died in hospital	All	
With stroke	Median (days)	
65–69	8	38	25	9	5	9	
70–74	11	33.5	29	10	6	10	
75–79	9	31	28	10	7	11	
80–84	10	30	24.5	11	8	12	
85–89	10	28	25.5	12	7	12	
90–94	10	27	21	12	7	11	
95+	11	22	17.5	10	7	10	
All with stroke	10	29	25	10	7	11	
Without stroke							
65–69	6	25	13	3	8	3	
70–74	6	23	13	4	7	4	
75–79	6	24	14	4	8	4	
80–84	6	23	14	5	8	5	
85–89	6	23	13	5	7	6	
90–94	6	21	13	6	7	6	
95+	5	21	14	6	7	6	
All without stroke	6	23	14	4	7	4	
All							
65–69	6	26	14	3	7	4	
70–74	6	25	14	4	7	4	
75–79	6	25	14	4	8	5	
80–84	6	24	14	5	8	5	
85–89	6	23	14	5	7	6	
90–94	6	22	13	6	7	6	
95+	5	21	14	6	7	6	
All separations	6	24	14	4	7	5	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
Table 6.17:	Hospital separations for people aged 65+: median length of stay in hospital, by principal diagnosis of injury caused by a fall, age and movement type, 2001–02 (unadjusted)
Principal diagnosis injury with fall/age	Returning to permanent RAC	To permanent RAC	To 
respite
 RAC	To community/
other	Died in hospital	All	
With injury and fall	Median (days)	
65–69	6	21.5	20	3	6	4	
70–74	6	23	15.5	4	8	4	
75–79	6	26	15	5	8	6	
80–84	6	22	15	6	8	6	
85–89	6	25	14	7	7	7	
90–94	6	25	14	6	8	7	
95+	6	24	15	6	8	7	
All with injury and fall	6	24	15	5	8	6	
Without injury and fall							
65–69	6	27	13	3	7	4	
70–74	6	25	14	4	7	4	
75–79	6	25	14	4	8	5	
80–84	6	24	14	5	8	5	
85–89	6	23	14	5	7	6	
90–94	6	22	13	6	7	6	
95+	5	21	14	6	7	6	
All without injury and fall	6	23	14	4	7	5	
All							
65–69	6	26	14	3	7	4	
70–74	6	25	14	4	7	4	
75–79	6	25	14	4	8	5	
80–84	6	24	14	5	8	5	
85–89	6	23	14	5	7	6	
90–94	6	22	13	6	7	6	
95+	5	21	14	6	7	6	
All separations	6	24	14	4	7	5	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of hospital admission.
6.5	Short-term use of residential aged care
People moving from hospital to respite RAC with a hospital diagnosis of dementia were more likely than those without such a diagnosis to return to the community within 12 weeks of admission (66% of people admitted to respite care with a hospital diagnosis of dementia compared with 52% of those without) (Table 6.18). However, a relatively large proportion (19% versus 11%) left respite care reporting that they were going to another RAC service—a move that was not identified as occurring within 4 weeks. As a result of the lower rate of returning to the community, people without a diagnosis of dementia were much more likely to be still in respite care at the 12 week mark (25% of those without a hospital diagnosis of dementia compared with 4% of those with such a diagnosis). 
Among people moving into permanent care, the differences in short-term outcomes for those with and without a diagnosis of dementia were small: people with a hospital diagnosis of dementia were slightly more likely than others to end with a return to the community within 12 weeks (10% compared with 8%), and less likely to have died within that period (17% versus 20%).
Few people with a diagnosis of stroke moved from hospital to RAC for respite care (Table 6.19). Those that did were more likely than others to return to the community within 12 weeks (75% compared with 58%). Few people entering respite care from hospital with a diagnosis of stroke were still in RAC at 12 weeks. For people admitted to permanent care from hospital, relatively few with a hospital diagnosis of stroke returned to the community within 12 weeks (6% versus 9%). There was no significant difference between the proportions that were discharged to hospital or died in care within 12 weeks for those with and without stroke. As a result, more people with a stroke diagnosis were still in permanent care at the 12 week point than those without such a diagnosis.
As with stroke, relatively few people in hospital because of a fall moved from hospital to RAC for respite care, and those that did were more likely than others to return to the community within 12 weeks (77% compared with 58%) (Table 6.20). Consequently, few were still in residential care after 12 weeks. Similarly, among transitions to permanent care from hospital, relatively few residents who were in hospital due to a fall returned to the community within 12 weeks (7% versus 9%, p<0.05). There were no other significant differences in the short-term outcomes for people according to whether they had been in hospital because of a fall.

Table 6.18:	People aged 65+ returning to the community following RAC admission from hospital: any diagnosis of dementia, by admission type, 2001–02 (unadjusted)
Movement following admission to RAC	Transition into respite RAC		Transition into permanent RAC		All into RAC	
	Any diagnosis 
of dementia			Any diagnosis 
of dementia					
	Yes	No	All		Yes	No	All		All	N	
Returned to the community within 12 weeks	Column per cent		
Did not return to RAC within 4 weeks											
Left reported going to RAC	19.4	10.9	11.7		1.2	1.1	1.2		4.1	796	
Other	46.6	40.7	41.2		7.3	6.0	6.4		16.2	3,136	
Subtotal	66.0	51.5	52.9		8.5	7.1	7.6		20.3	3,932	
Returned to RAC within 4 weeks 											
Re-admission into respite RAC	1.6	5.0	4.7		—	—	—		1.3	253	
Re-admission into permanent RAC	4.1	0.6	1.0		1.0	0.9	0.9		0.9	181	
Subtotal	5.6	5.6	5.6		1.0	0.9	0.9		2.2	434	
Total returns to the community	71.7	57.1	58.5		9.5	8.0	8.5		22.5	4,366	
Did not return to the community within 12 weeks											
In respite RAC after 12 weeks	3.5	25.4	23.3		—	—	—		6.5	1,264	
In permanent RAC after 12 weeks	2.5	0.9	1.0		71.4	70.6	70.9		51.3	9,953	
Discharged to hospital within 12 weeks	15.0	11.0	11.3		2.3	1.7	1.9		4.5	875	
Died in RAC within 12 weeks	7.4	5.7	5.8		16.7	19.7	18.8		15.1	2,937	
Total non-returners to the community 	28.3	42.9	41.5		90.5	92.0	91.5		77.5	15,029	
Total	100.0	100.0	100.0		100.0	100.0	100.0		100	. .	
Total (people)	515	4,912	5,427		4,553	9,415	13,968		. .	19,395	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of initial RAC admission from hospital. 
4.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.

Table 6.19:	People aged 65+ returning to the community following RAC admission from hospital: any diagnosis of stroke, by admission type, 2001–02 (unadjusted)
Movement following admission to RAC	Transition into respite RAC		Transition into permanent RAC		All into RAC	
	Any diagnosis 
of stroke			Any diagnosis 
of stroke					
	Yes	No	All		Yes	No	All		All	N	
Returned to the community within 12 weeks	Column per cent		
Did not return to RAC within 4 weeks											
Left reported going to RAC	22.6	11.4	11.7		0.5	1.3	1.2		4.1	796	
Other	48.9	41.0	41.2		4.3	6.7	6.4		16.2	3,136	
Subtotal	71.5	52.4	52.9		4.8	7.9	7.6		20.3	3,932	
Returned to RAC within 4 weeks 											
Re-admission into respite RAC	n.p.	4.7	4.7		—	—	—		1.3	253	
Re-admission into permanent RAC	n.p.	0.9	1.0		0.8	0.9	0.9		0.9	181	
Subtotal	3.6	5.7	5.6		0.8	0.9	0.9		2.2	434	
Total returns to the community	75.2	58.1	58.5		5.6	8.9	8.5		22.5	4,366	
Did not return to the community within 12 weeks											
In respite RAC after 12 weeks	<3.6	23.8	23.3		—	—	—		6.5	1,264	
In permanent RAC after 12 weeks	<3.6	1.0	1.0		73.1	70.6	70.9		51.3	9,953	
Discharged to hospital within 12 weeks	8.0	11.4	11.3		1.2	1.9	1.9		4.5	875	
Died in RAC within 12 weeks	10.9	5.7	5.8		20.2	18.6	18.8		15.1	2,937	
Total non-returners to the community 	24.8	41.9	41.5		94.4	91.1	91.5		77.5	15,029	
Total	100.0	100.0	100.0		100.0	100.0	100.0		100.0	. .	
Total (people)	137	5,290	5,427		1,552	12,416	13,968		. .	19,395	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of initial RAC admission from hospital. 
4.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.

Table 6.20:	People aged 65+ returning to the community following RAC admission from hospital: principal diagnosis of injury external cause of fall, by admission type, 2001–02 (unadjusted)
Movement following admission to RAC	Transition into respite RAC		Transition into permanent RAC		All into RAC	
	Principal diagnosis of injury caused by a fall 			Principal diagnosis of injury caused by a fall 					
	Yes	No	All		Yes	No	All		All	N	
Returned to the community within 12 weeks	Column per cent		
Did not return to RAC within 4 weeks											
Left reported going to RAC	16.3	11.4	11.7		0.8	1.2	1.2		4.1	796	
Other	58.2	40.3	41.2		5.1	6.5	6.4		16.2	3,136	
Subtotal	74.5	51.7	52.9		5.9	7.7	7.6		20.3	3,932	
Returned to RAC within 4 weeks 											
Re-admission into respite RAC	n.p.	4.9	4.7		—	—	—		1.3	253	
Re-admission into permanent RAC	n.p.	0.9	1.0		0.9	0.9	0.9		0.9	181	
Subtotal	2.8	5.8	5.6		0.9	0.9	0.9		2.2	434	
Total returns to the community	77.3	57.5	58.5		6.8	8.6	8.5		22.5	4,366	
Did not return to the community within 12 weeks											
In respite RAC after 12 weeks	<1.8	24.4	23.3		—	—	—		6.5	1,264	
In permanent RAC after 12 weeks	<1.8	1.0	1.0		72.3	70.8	70.9		51.3	9,953	
Discharged to hospital within 12 weeks	14.2	11.2	11.3		1.4	1.9	1.9		4.5	875	
Died in RAC within 12 weeks	5.0	5.9	5.8		19.5	18.7	18.8		15.1	2,937	
Total non-returners to the community 	22.7	42.5	41.5		93.2	91.4	91.5		77.5	15,029	
Total	100.0	100.0	100.0		100.0	100.0	100.0		100.0	..	
Total (people)	282	5,145	5,427		847	13,121	13,968		..	19,395	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Diagnoses relate to those recorded during the last hospital episode before discharge from the hospital system (see boxes 1.1 and 6.1).
3.	Age is as at time of initial RAC admission from hospital. 
4.	Table is based on first admission from hospital during the first 36 weeks of 2001–02 to allow a 12-week window to identify returns to the community followed by a 4-week window to identify unsuccessful returns.

7	Refining the methods
In the course of undertaking this study, a number of areas where improvements in data availability or structure could enhance the utility and accuracy of analyses were identified. These are discussed below.
1. Data items included in the analysis 
When obtaining permissions to use the NHMD and ACCMIS data sets in data linkage studies, the specific data items to be included have to be specified. For this project, a parsimonious approach was taken to selecting data items for inclusion in the analysis. Since analysis of linked NHMD and RAC data had not previously been carried out a number of data items were omitted which, in hindsight, could have enhanced the analysis. For example, in the hospital data only hospital sector (public versus private) was included in the analysis data set whereas analysis by sector of both the hospital and the patient (that is, patient election status) is of interest. Also, in the RAC data, living arrangements prior to admission could have proved useful in the analysis of propensity to move from hospital into permanent RAC. 
The experience from this study therefore suggests that a more inclusive approach should be taken when specifying data items to be included in analysis data sets from the NHMD and ACCMIS. Such an approach would make the linked data set useful for a wider range of investigations.
2. History of use of RAC
In the current analysis, data on the use of RAC was restricted to the year of interest 
(2001–02). However, information on prior and later use of RAC would both improve data available for modelling behaviour and improve data quality for looking at short-term and medium-term outcomes. For example, having data on later use of RAC would allow a full year’s data to be used when investigating short-term use of RAC (Section 5.2), and would reduce the level of censoring in the data for the survival analysis (Section 5.3).
3. Mortality data
In analysis of person outcomes, knowledge of whether a person has died can be important. For example, in the analysis of short-term use of RAC presented in Section 5.2, a number of people ‘Left reported going to RAC’ but were not identified as later returning to RAC. Knowing whether or not these people had died would add a further dimension to the story. 
In addition, in the analysis of survival following admission into permanent RAC, better death information—in particular, for those who were discharged to hospital—would increase the quality of the data for analysis (by reducing the level of censored data) and so would lead to more reliable models.
Better identification of death could be achieved by linking the National Death Index (NDI) with the RAC data on ACCMIS. As name and date of birth information are on both data sets the linkage would be name based. As well as identifying date of death, such linkage would allow cause of death data to be included in the analysis data set. Note, that such name-based linkage could only be undertaken for people using RAC as the NHMD does not contain name information. While, it may be feasibile to link deaths in hospital with the NDI using 
event-based linkage, date of death and reason of death data could not be obtained for people who returned to the community after their period in hospital as there are insufficient data to link the NHMD and NDI data sets for these people.
4. Identification of complete hospital stay
In the current NHMD, a person can have several hospital episodes relating to the one hospitalisation. Using episodic data means that for some people their total length of stay in hospital is underestimated and their in-hospital care history incomplete. For the current analysis of transitions, hospital episodes that ended with a movement within the hospital system were excluded from the analysis as they should not have related to movement from hospital to RAC. Consequently, the information for analysis was, of necessity, that associated with the final episode before discharge from hospital. This shortcoming can only be overcome if data on all episodes relating to a single period in hospital can be combined.
Currently, in the NHMD there is neither a name nor a person identifier, nor even some sort of hospital stay identifier, to facilitate joining together contiguous episodes in hospital for the same person. However, such linkage within the hospital data may be possible using 
event-based linkage similar to that used for this project. The effectiveness of this approach has yet to be investigated, but is expected to be high—especially when linking episodes within the same hospital. Undertaking this within-NHMD linkage before linking to the RAC data would both increase the accuracy of the between-sector data linkage and provide improved information on the period in hospital for analysis.
5. Identification of bi-directional movement
The linkage process used for this publication allows the identification of uni-directional movement from hospital into RAC. While this analysis has provided some information on the use of hospital by people living in RAC, a fuller investigation could be undertaken if transitions in both directions could be identified. To do this, both the data preparation and linkage processes would have to be adjusted to enable identification of:
•	discharge from RAC directly into hospital 
•	discharge from RAC into hospital while on hospital leave from RAC.
In particular, hospital episodes starting with an admission into the hospital system, irrespective of whether they ended with discharge from the sector, would need to be included in the NHMD data set for linkage. For identification of uni-directional movements from RAC to hospital, data linkage could be undertaken using a similar approach to that taken here, except that episodes starting—rather than ending—with a statistical admission or transfer would be excluded. If integrated analysis of movements in both directions were to be required, linkage of contiguous hospital episodes (as above) to obtain hospitalisation dates covering the total period in hospital would be necessary. 
Of the above developments, the first two are the most readily achievable, with the remaining three requiring considerable investment in linking—either between or within data sets.
Appendix A: Additional tables
Table A.1: 	All hospital separations by hospital admission mode and care type, people aged 65+, 2001–02 (unadjusted)
Movement type/hospital admission mode	Acute	Rehabil-itation	Pallia-tive	GEM	Psycho-geriatric	Mainten-ance	Other	All	Total separations	
Returning to permanent RAC	Per cent within movement and care type	Number	
Transfer from another hospital	4.9	47.9	9.9	36.3	14.0	9.9	4.8	7.3	3,506	
Change in care type	0.3	42.1	16.4	42.5	7.0	79.9	47.6	3.2	1,559	
Total	5.1	90.0	26.3	78.8	21.1	89.8	52.4	10.5	5,065	
Total separations (number)	44,655	2,181	171	551	228	283	42	. .	48,111	
To permanent RAC										
Transfer from another hospital	12.9	46.7	28.8	39.5	27.4	10.0	9.2	18.3	3,659	
Change in care type	3.5	43.6	19.6	41.6	25.3	81.5	83.5	32.9	6,585	
Total	16.4	90.3	48.4	81.1	52.7	91.5	92.8	51.1	10,244	
Total separations (number)	10,208	2,104	372	1,665	186	4,334	1,159	. .	20,028	
To respite RAC										
Transfer from another hospital	11.7	49.6	21.6	30.5	19.2	9.8	10.5	16.8	1,301	
Change in care type	1.5	40.6	24.3	45.7	25.0	75.2	75.0	15.3	1,185	
Total	13.2	90.2	45.9	76.2	44.2	85.0	85.5	32.2	2,486	
Total separations (number)	5,669	978	74	151	52	727	76	. .	7,727	
To community/other										
Transfer from another hospital	5.3	58.8	13.5	33.8	22.1	8.1	5.9	8.0	65,157	
Change in care type	0.2	28.7	12.4	37.1	14.5	46.0	59.4	2.4	19,195	
Total	5.5	87.5	25.9	70.8	36.6	54.1	65.3	10.4	84,352	
Total separations (number)	757,516	37,242	4,379	6,017	916	5,356	2,341	. .	813,767	
Died in hospital										
Transfer from another hospital	11.2	41.7	29.3	45.4	39.3	14.1	9.8	15.1	7,761	
Change in care type	1.6	50.4	18.6	37.3	21.4	70.9	78.3	7.6	3,908	
Total	12.7	92.1	47.9	82.7	60.7	85.0	88.2	22.7	11,669	
Total separations (number)	39,818	607	8,671	624	56	1,301	254	. .	51,331	
All										
Transfer from another hospital	5.7	57.2	23.9	35.7	22.0	9.6	7.2	8.6	81,384	
Change in care type	0.3	30.7	16.7	38.4	15.4	64.1	68.0	3.4	32,432	
Total	6.0	87.9	40.6	74.1	37.4	73.7	75.3	12.1	113,816	
Total separations (number)	857,866	43,112	13,667	9,008	1,438	12,001	3,872	. .	940,964	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Per cent of hospital separations starting with admission into the hospital system are not explicitly given, but may be obtained by subtraction.
3.	7,197 records excluded due to missing care type and/or admission mode. 
Table A.2:	Hospital separations for people aged 65+, by movement type, age and sex, New South Wales, 2001–02 (unadjusted)
	Age at hospital admission			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	 6.3 	 13.4 	 20.4 	 24.6 	 22.3 	 10.3 	 2.7 	 100.0 	 5,041 	
To permanent RAC	 5.1 	 12.0 	 21.6 	 27.0 	 21.4 	 10.2 	 2.8 	 100.0 	 2,795 	
To respite RAC	 6.5 	 12.3 	 25.2 	 26.5 	 17.9 	 9.6 	 2.0 	 100.0 	 1,118 	
Subtotal	 6.0 	 12.8 	 21.4 	 25.6 	 21.5 	 10.2 	 2.6 	 100.0 	 8,954 	
To community/other	 21.6 	 25.5 	 24.9 	 17.2 	 8.1 	 2.3 	 0.3 	 100.0 	 129,667 	
Died in hospital	 12.1 	 18.9 	 24.4 	 21.4 	 15.6 	 6.2 	 1.5 	 100.0 	 9,412 	
All	 20.1 	 24.3 	 24.7 	 18.0 	 9.4 	 3.0 	 0.6 	 100.0 	. .	
Total separations (number)	 29,743 	 36,013 	 36,554 	 26,595 	 13,864 	 4,449 	 815 	 . . 	 148,033 	
Women	Row per cent		
To RAC			
Return to permanent RAC	2.5	5.7	12.9	23.5	30.2	19.2	6.0	100.0	 10,795 	
To permanent RAC	3.0	7.3	14.5	24.6	28.3	17.3	5.0	100.0	 4,484 	
To respite RAC	3.3	8.3	18.0	27.5	26.0	13.7	3.1	100.0	 2,147 	
Subtotal	2.7	6.5	13.9	24.3	29.2	18.1	5.4	100.0	 17,426 	
To community/other	17.1	21.4	24.1	19.7	12.4	4.5	0.9	100.0	 134,794 	
Died in hospital	8.9	13.1	19.9	22.2	20.9	11.4	3.6	100.0	 8,462 	
All	15.1	19.4	22.8	20.3	14.6	6.3	1.5	100.0	 . . 	
Total separations (number)	 24,240 	 31,106 	 36,603 	 32,616 	 23,516 	 10,190 	 2,411 	 . . 	 160,682 	
All	Row per cent		
To RAC			
Return to permanent RAC	3.7	8.2	15.3	23.8	27.7	16.4	4.9	100.0	 15,836 	
To permanent RAC	3.8	9.1	17.2	25.5	25.7	14.5	4.1	100.0	 7,279 	
To respite RAC	4.4	9.7	20.5	27.1	23.2	12.3	2.7	100.0	 3,265 	
Subtotal	3.8	8.6	16.5	24.7	26.6	15.4	4.4	100.0	 26,380 	
To community/other	19.3	23.4	24.5	18.5	10.3	3.4	0.6	100.0	 264,461 	
Died in hospital	10.6	16.1	22.3	21.8	18.1	8.7	2.5	100.0	 17,874 	
All	17.5	21.7	23.7	19.2	12.1	4.7	1.0	100.0	 . . 	
Total separations (number)	 53,983 	 67,119 	 73,157 	 59,211 	 37,380 	 14,639 	 3,226 	 . . 	 308,715 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
Table A.3:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, New South Wales, 2001–02 (unadjusted)
Sex/age	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–69	59.7	26.6	13.7	100.0	534	1.9	2.1	
70–74	58.8	29.2	12.0	100.0	1,149	3.4	3.7	
75–79	53.7	31.5	14.7	100.0	1,915	5.6	6.2	
Subtotal 65–79	56.3	30.0	13.7	100.0	3,598	3.7	4.1	
80–84	54.1	32.9	12.9	100.0	2,289	9.3	10.4	
85–89	58.4	31.2	10.4	100.0	1,921	15.5	17.2	
90–94	57.0	31.2	11.8	100.0	909	23.5	26.1	
95+	58.2	32.5	9.3	100.0	237	35.2	39.1	
Subtotal 80+	56.3	32.0	11.7	100.0	5,356	12.9	14.3	
All	56.3	31.2	12.5	100.0	. .	6.5	7.2	
Total sep’s (N)	5,041	2,795	1,118	. .	8,954	       138,621	
Women								
65–69	56.7	28.2	15.1	100.0	471	2.0	2.2	
70–74	54.9	29.2	15.9	100.0	1,127	3.8	4.2	
75–79	57.3	26.8	15.9	100.0	2,428	7.0	7.7	
Subtotal 65–79	56.6	27.6	15.8	100.0	4,026	4.6	5.1	
80–84	60.0	26.1	13.9	100.0	4,230	13.8	15.3	
85–89	64.1	25.0	11.0	100.0	5,089	23.4	26.0	
90–94	66.0	24.6	9.4	100.0	3,147	34.1	37.9	
95+	69.0	23.9	7.2	100.0	934	44.3	49.3	
Subtotal 80+	63.6	25.2	11.3	100.0	13,400	21.0	23.4	
All	61.9	25.7	12.3	100.0	. .	11.4	12.7	
Total sep’s (N)	10,795	4,484	2,147	. .	17,426	       152,220	
All								
65–69	58.3	27.4	14.3	100.0	1,005	1.9	2.1	
70–74	56.9	29.2	13.9	100.0	2,276	3.5	3.9	
75–79	55.7	28.9	15.4	100.0	4,343	6.3	7.0	
Subtotal 65–79	56.4	28.8	14.8	100.0	7,624	4.1	4.6	
80–84	57.9	28.5	13.6	100.0	6,519	11.8	13.1	
85–89	62.5	26.7	10.8	100.0	7,010	20.5	22.8	
90–94	64.0	26.1	9.9	100.0	4,056	31.0	34.5	
95+	66.8	25.6	7.6	100.0	1,171	42.1	46.9	
Subtotal 80+	61.5	27.1	11.4	100.0	18,756	17.8	19.8	
All	60.0	27.6	12.4	100.0	. .	9.1	10.1	
Total separations (number)	15,836	7,279	3,265	. .	26,380	      290,841	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
Table A.4:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, New South Wales, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To
 respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–69	142	73	215	1.9	:	1	
70–74	335	138	473	2.4	:	1	
75–79	604	282	886	2.1	:	1	
Subtotal 65–79	1,081	493	1,574	2.2	:	1	
80–84	754	296	1,050	2.5	:	1	
85–89	599	200	799	3.0	:	1	
90–94	284	107	391	2.7	:	1	
95+	77	22	99	3.5	:	1	
Subtotal 80+	1,714	625	2,339	2.7	:	1	
All	2,795	1,118	3,913	2.5	:	1	
Women							
65–69	133	71	204	1.9	:	1	
70–74	329	179	508	1.8	:	1	
75–79	651	386	1,037	1.7	:	1	
Subtotal 65–79	1,113	636	1,749	1.8	:	1	
80–84	1,103	590	1,693	1.9	:	1	
85–89	1,270	559	1,829	2.3	:	1	
90–94	775	295	1,070	2.6	:	1	
95+	223	67	290	3.3	:	1	
Subtotal 80+	3,371	1,511	4,882	2.2	:	1	
All	4,484	2,147	6,631	2.1	:	1	
All							
65–69	275	144	419	1.9	:	1	
70–74	664	317	981	2.1	:	1	
75–79	1,255	668	1,923	1.9	:	1	
Subtotal 65–79	2,194	1,129	3,323	1.9	:	1	
80–84	1,857	886	2,743	2.1	:	1	
85–89	1,869	759	2,628	2.5	:	1	
90–94	1,059	402	1,461	2.6	:	1	
95+	300	89	389	3.4	:	1	
Subtotal 80+	5,085	2,136	7,221	2.4	:	1	
All	7,279	3,265	10,544	2.2	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.5:	Hospital separations for people aged 65+, by movement type, age and sex, Victoria, 
2001–02 (unadjusted)
	Age at hospital admission			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	6.1	10.5	18.8	22.6	24.0	14.3	3.6	100.0	3,346	
To permanent RAC	5.3	11.0	20.4	26.1	24.2	10.9	2.1	100.0	1,956	
To respite RAC	5.4	10.2	19.9	27.9	22.7	11.6	2.4	100.0	423	
Subtotal	5.8	10.7	19.4	24.2	24.0	12.9	3.0	100.0	5,725	
To community/other	21.3	25.3	25.0	16.8	8.6	2.6	0.4	100.0	104,266	
Died in hospital	11.4	19.1	23.7	20.5	16.3	7.5	1.5	100.0	7,129	
All	20.0	24.2	24.6	17.4	9.8	3.4	0.6	100.0	. . 	
Total separations (number)	23,370	28,379	28,844	20,414	11,461	3,964	688	. .	117,120	
Women	Row per cent		
To RAC			
Return to permanent RAC	2.1	4.8	13.0	22.4	30.7	19.9	7.2	100.0	 7,293 	
To permanent RAC	2.4	6.6	16.0	24.4	27.8	17.4	5.4	100.0	 3,487 	
To respite RAC	2.9	7.2	17.1	29.7	30.3	9.9	2.9	100.0	 780 	
Subtotal	2.2	5.5	14.2	23.5	29.8	18.5	6.3	100.0	 11,560 	
To community/other	16.9	20.6	23.7	19.6	13.3	4.9	1.0	100.0	 108,810 	
Died in hospital	7.9	12.9	19.3	21.8	22.1	12.0	4.0	100.0	 6,611 	
All	15.1	18.9	22.6	20.0	15.3	6.5	1.7	100.0	 . . 	
Total separations (number)	 19,134 	 23,938 	 28,739 	 25,447 	 19,382 	 8,235 	 2,106 	 . . 	 126,981 	
All	Row per cent		
To RAC			
Return to permanent RAC	3.3	6.6	14.8	22.5	28.6	18.2	6.0	100.0	 10,639 	
To permanent RAC	3.5	8.2	17.6	25.0	26.5	15.1	4.2	100.0	 5,443 	
To respite RAC	3.8	8.2	18.0	29.1	27.6	10.5	2.7	100.0	 1,203 	
Subtotal	3.4	7.2	15.9	23.7	27.9	16.7	5.2	100.0	 17,285 	
To community/other	19.0	22.9	24.3	18.2	11.0	3.8	0.7	100.0	 213,076 	
Died in hospital	9.7	16.1	21.6	21.2	19.1	9.6	2.7	100.0	 13,740 	
All	17.4	21.4	23.6	18.8	12.6	5.0	1.1	100.0	 . . 	
Total separations (number)	 42,504	 52,317 	 57,583	 45,861	 30,843	 12,199	 2,794	 . . 	 244,101	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
Table A.6:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Victoria, 2001–02
Sex/age	Returning to permanent RAC	To permanent RAC	To
 respite
 RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–69	61.7	31.3	6.9	100.0	332	1.5	1.6	
70–74	57.8	35.2	7.0	100.0	611	2.3	2.5	
75–79	56.6	35.8	7.5	100.0	1,113	4.1	4.6	
Subtotal 65–79	57.8	34.9	7.3	100.0	2,056	2.7	3.0	
80–84	54.7	36.8	8.5	100.0	1,385	7.3	8.1	
85–89	58.5	34.5	7.0	100.0	1,372	13.3	14.8	
90–94	64.6	28.8	6.6	100.0	740	21.6	24.0	
95+	69.8	24.4	5.8	100.0	172	29.7	33.0	
Subtotal 80+	58.8	33.7	7.4	100.0	3,669	11.0	12.3	
All	58.4	34.2	7.4	100.0	. .	5.2	5.8	
Total sep’s (N)	3,346	1,956	423	. .	5,725	     109,991	
Women								
65–69	58.3	32.8	8.9	100.0	259	1.4	1.5	
70–74	54.9	36.2	8.9	100.0	632	2.7	3.0	
75–79	57.8	34.1	8.1	100.0	1,638	6.0	6.6	
Subtotal 65–79	57.1	34.5	8.4	100.0	2,529	3.7	4.1	
80–84	60.1	31.4	8.5	100.0	2,716	11.3	12.6	
85–89	65.1	28.1	6.9	100.0	3,445	19.2	21.4	
90–94	68.0	28.4	3.6	100.0	2,138	28.7	31.9	
95+	71.3	25.5	3.1	100.0	732	39.7	44.2	
Subtotal 80+	64.8	28.9	6.3	100.0	9,031	17.6	19.6	
All	63.1	30.2	6.7	100.0	. .	9.6	10.7	
Total sep’s (N)	7,293	3,487	780	. .	11,560	     120,370	
All								
65–69	60.2	32.0	7.8	100.0	591	1.4	1.6	
70–74	56.3	35.7	8.0	100.0	1,243	2.5	2.8	
75–79	57.3	34.8	7.9	100.0	2,751	5.0	5.6	
Subtotal 65–79	57.4	34.7	7.9	100.0	4,585	3.1	3.5	
80–84	58.3	33.2	8.5	100.0	4,101	9.5	10.6	
85–89	63.2	29.9	6.9	100.0	4,817	17.1	19.0	
90–94	67.1	28.5	4.4	100.0	2,878	26.5	29.4	
95+	71.0	25.3	3.7	100.0	904	37.3	41.5	
Subtotal 80+	63.0	30.3	6.6	100.0	12,700	15.0	16.7	
All	61.6	31.5	7.0	100.0	. .	7.5	8.3	
Total separations (number)	10,639	5,443	1,203	. .	17,285	     230,361	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
Table A.7:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Victoria, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–69	104	23	127	4.5	:	1	
70–74	215	43	258	5.0	:	1	
75–79	399	84	483	4.8	:	1	
Subtotal 65–79	718	150	868	4.8	:	1	
80–84	510	118	628	4.3	:	1	
85–89	473	96	569	4.9	:	1	
90–94	213	49	262	4.3	:	1	
95+	42	10	52	4.2	:	1	
Subtotal 80+	1,238	273	1,511	4.5	:	1	
All	1,956	423	2,379	4.6	:	1	
Women							
65–69	85	23	108	3.7	:	1	
70–74	229	56	285	4.1	:	1	
75–79	559	133	692	4.2	:	1	
Subtotal 65–79	873	212	1,085	4.1	:	1	
80–84	852	232	1,084	3.7	:	1	
85–89	968	236	1,204	4.1	:	1	
90–94	607	77	684	7.9	:	1	
95+	187	23	210	8.1	:	1	
Subtotal 80+	2,614	568	3,182	4.6	:	1	
All	3,487	780	4,267	4.5	:	1	
All							
65–69	189	46	235	4.1	:	1	
70–74	444	99	543	4.5	:	1	
75–79	958	217	1,175	4.4	:	1	
Subtotal 65–79	1,591	362	1,953	4.4	:	1	
80–84	1,362	350	1,712	3.9	:	1	
85–89	1,441	332	1,773	4.3	:	1	
90–94	820	126	946	6.5	:	1	
95+	229	33	262	6.9	:	1	
Subtotal 80+	3,852	841	4,693	4.6	:	1	
All	5,443	1,203	6,646	4.5	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.8:	Hospital separations for people aged 65+, by movement type, age and sex, Queensland, 2001–02 (unadjusted)
	Age at hospital admission			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	 5.4 	 11.2 	 16.8 	 27.1 	 22.4 	 13.9 	 3.2 	 100.0 	 3,332 	
To permanent RAC	 5.1 	 12.0 	 21.7 	 25.9 	 22.7 	 10.7 	 2.0 	 100.0 	 1,381 	
To respite RAC	 5.1 	 11.9 	 20.1 	 29.7 	 21.8 	 9.5 	 1.9 	 100.0 	 528 	
Subtotal	 5.3 	 11.5 	 18.4 	 27.0 	 22.4 	 12.6 	 2.7 	 100.0 	 5,241 	
To community/other	 22.2 	 24.2 	 25.3 	 17.6 	 8.3 	 2.2 	 0.3 	 100.0 	 79,488 	
Died in hospital	 12.5 	 17.9 	 24.2 	 21.5 	 15.8 	 6.3 	 1.7 	 100.0 	 4,897 	
All	 20.6 	 23.1 	 24.8 	 18.3 	 9.5 	 3.1 	 0.6 	 100.0 	. .	
Total separations (number)	 18,505 	 20,685 	 22,232 	 16,443 	 8,523 	 2,739 	 499 	 . . 	 89,626 	
Women	Row per cent		
To RAC			
Return to permanent RAC	2.2	5.6	13.2	25.7	30.5	17.5	5.3	100.0	 6,756 	
To permanent RAC	3.0	8.0	14.9	27.4	26.9	15.8	4.0	100.0	 2,074 	
To respite RAC	2.7	9.4	18.9	30.3	23.7	11.6	3.4	100.0	 882 	
Subtotal	2.5	6.5	14.1	26.5	29.1	16.6	4.9	100.0	 9,712 	
To community/other	18.4	21.8	23.8	19.7	11.5	4.0	0.8	100.0	 76,308 	
Died in hospital	8.6	13.4	18.9	22.2	20.7	12.2	4.0	100.0	 4,151 	
All	16.2	19.8	22.6	20.6	13.8	5.7	1.4	100.0	 . . 	
Total separations (number)	 14,602 	 17,839 	 20,344 	 18,540 	 12,434 	 5,147 	 1,265 	 . . 	 90,171 	
All	Row per cent		
To RAC			
Return to permanent RAC	3.3	7.5	14.4	26.1	27.8	16.3	4.6	100.0	 10,088 	
To permanent RAC	3.8	9.6	17.6	26.8	25.2	13.8	3.2	100.0	 3,455 	
To respite RAC	3.6	10.4	19.4	30.1	23.0	10.8	2.8	100.0	 1,410 	
Subtotal	3.5	8.2	15.6	26.7	26.8	15.2	4.1	100.0	 14,953 	
To community/other	20.3	23.0	24.6	18.6	9.8	3.1	0.6	100.0	 155,796 	
Died in hospital	10.7	15.9	21.8	21.8	18.1	9.0	2.7	100.0	 9,048 	
All	18.4	21.4	23.7	19.5	11.7	4.4	1.0	100.0	 . . 	
Total separations (number)	 33,107 	 38,524 	 42,576 	 34,983 	 20,957 	 7,886 	 1,764 	 . . 	 179,797 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
Table A.9:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Queensland, 2001–02 
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–69	65.1	25.2	9.7	100.0	278	1.6	1.7	
70–74	61.9	27.6	10.5	100.0	601	3.0	3.4	
75–79	58.0	31.0	11.0	100.0	965	4.6	5.1	
Subtotal 65–79	60.4	29.0	10.6	100.0	1,844	3.1	3.5	
80–84	63.7	25.2	11.1	100.0	1,417	9.2	10.2	
85–89	63.5	26.7	9.8	100.0	1,176	15.2	16.9	
90–94	70.0	22.4	7.6	100.0	661	27.2	30.2	
95+	74.1	18.9	7.0	100.0	143	34.2	38.1	
Subtotal 80+	65.3	24.9	9.8	100.0	3,397	13.1	14.5	
All	63.6	26.3	10.1	100.0	. .	6.2	6.9	
Total sep’s (N)	3,332	1,381	528	. .	5,241	               84,729	
Women								
65–69	63.6	26.4	10.0	100.0	239	1.7	1.9	
70–74	60.5	26.3	13.2	100.0	628	3.6	4.0	
75–79	65.2	22.6	12.2	100.0	1,366	7.0	7.8	
Subtotal 65–79	63.7	24.0	12.3	100.0	2,233	4.4	4.9	
80–84	67.5	22.1	10.4	100.0	2,569	14.6	16.2	
85–89	72.9	19.7	7.4	100.0	2,824	24.4	27.1	
90–94	73.3	20.3	6.3	100.0	1,613	34.8	38.7	
95+	76.1	17.5	6.3	100.0	473	43.0	47.8	
Subtotal 80+	71.3	20.6	8.1	100.0	7,479	21.4	23.8	
All	69.6	21.4	9.1	100.0	. .	11.3	12.6	
Total sep’s (N)	6,756	2,074	882	. .	9,712	              86,020	
All								
65–69	64.4	25.7	9.9	100.0	517	1.6	1.8	
70–74	61.2	26.9	11.9	100.0	1,229	3.3	3.7	
75–79	62.2	26.1	11.7	100.0	2,331	5.7	6.4	
Subtotal 65–79	62.2	26.3	11.5	100.0	4,077	3.7	4.1	
80–84	66.1	23.2	10.6	100.0	3,986	12.1	13.4	
85–89	70.1	21.8	8.1	100.0	4,000	20.7	23.0	
90–94	72.4	20.9	6.7	100.0	2,274	32.2	35.8	
95+	75.6	17.9	6.5	100.0	616	40.6	45.1	
Subtotal 80+	69.4	21.9	8.6	100.0	10,876	17.9	19.9	
All	67.5	23.1	9.4	100.0	. .	8.8	9.7	
Total separations (number)	10,088	3,455	1,410	. .	14,953	              170,749	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
Table A.10:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Queensland, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–69	70	27	97	2.6	:	1	
70–74	166	63	229	2.6	:	1	
75–79	299	106	405	2.8	:	1	
Subtotal 65–79	535	196	731	2.7	:	1	
80–84	357	157	514	2.3	:	1	
85–89	314	115	429	2.7	:	1	
90–94	148	50	198	3.0	:	1	
95+	27	10	37	2.7	:	1	
Subtotal 80+	846	332	1,178	2.5	:	1	
All	1,381	528	1,909	2.6	:	1	
Women							
65–69	63	24	87	2.6	:	1	
70–74	165	83	248	2.0	:	1	
75–79	309	167	476	1.9	:	1	
Subtotal 65–79	537	274	811	2.0	:	1	
80–84	569	267	836	2.1	:	1	
85–89	557	209	766	2.7	:	1	
90–94	328	102	430	3.2	:	1	
95+	83	30	113	2.8	:	1	
Subtotal 80+	1,537	608	2,145	2.5	:	1	
All	2,074	882	2,956	2.4	:	1	
All							
65–69	133	51	184	2.6	:	1	
70–74	331	146	477	2.3	:	1	
75–79	608	273	881	2.2	:	1	
Subtotal 65–79	1,072	470	1,542	2.3	:	1	
80–84	926	424	1,350	2.2	:	1	
85–89	871	324	1,195	2.7	:	1	
90–94	476	152	628	3.1	:	1	
95+	110	40	150	2.8	:	1	
Subtotal 80+	2,383	940	3,323	2.5	:	1	
All	3,455	1,410	4,865	2.5	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.11:	Hospital separations for people aged 65+, by movement type, age and sex, Western Australia, 2001–02 (unadjusted)
	Age at hospital admission			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	 4.3 	 12.2 	 19.7 	 24.4 	 24.7 	 12.0 	 2.7 	 100.0 	 1,435 	
To permanent RAC	 5.3 	 12.0 	 20.3 	 23.4 	 22.8 	 13.6 	 2.6 	 100.0 	 492 	
To respite RAC	 7.6 	 17.3 	 24.1 	 19.8 	 19.4 	>9.7	<2.1	 100.0 	 237 	
Subtotal	 4.9 	 12.7 	 20.3 	 23.7 	 23.7 	 12.2 	 2.5 	 100.0 	 2,164 	
To community/other	 22.6 	 25.4 	 24.4 	 15.5 	 9.2 	 2.5 	 0.5 	 100.0 	 35,396 	
Died in hospital	 13.0 	 17.7 	 22.3 	 20.9 	 17.7 	 6.3 	 2.1 	 100.0 	 2,181 	
All	 21.1 	 24.2 	 24.1 	 16.3 	 10.4 	 3.2 	 0.7 	 100.0 	. .	
Total separations (number)	 8,380 	 9,635 	 9,568 	 6,465 	 4,141 	 1,283 	 269 	 . . 	 39,741 	
Women	Row per cent		
To RAC			
Return to permanent RAC	1.8	5.2	12.4	20.6	30.8	22.5	6.7	100.0	 3,355 	
To permanent RAC	2.3	5.8	15.0	23.8	29.8	17.6	5.7	100.0	 947 	
To respite RAC	2.0	7.2	17.5	29.6	28.5	12.9	2.2	100.0	 456 	
Subtotal	1.9	5.5	13.4	22.1	30.4	20.6	6.1	100.0	 4,758 	
To community/other	18.6	21.7	23.1	18.3	12.5	4.9	0.9	100.0	 37,074 	
Died in hospital	7.5	12.4	18.7	20.8	22.7	13.7	4.3	100.0	 2,116 	
All	16.3	19.5	21.8	18.9	14.9	7.0	1.7	100.0	 . . 	
Total separations (number)	 7,156 	 8,557 	 9,595 	 8,289 	 6,543 	 3,077 	 731 	 . . 	 43,948 	
All	Row per cent		
To RAC			
Return to permanent RAC	2.5	7.3	14.6	21.8	29.0	19.4	5.5	100.0	 4,790 	
To permanent RAC	3.3	7.9	16.8	23.6	27.4	16.3	4.7	100.0	 1,439 	
To respite RAC	3.9	10.7	19.8	26.3	25.4	12.3	1.7	100.0	 693 	
Subtotal	2.8	7.8	15.6	22.6	28.3	18.0	4.9	100.0	 6,922 	
To community/other	20.6	23.5	23.7	17.0	10.8	3.7	0.7	100.0	 72,470 	
Died in hospital	10.3	15.1	20.5	20.9	20.2	10.0	3.2	100.0	 4,297 	
All	18.6	21.7	22.9	17.6	12.8	5.2	1.2	100.0	 . . 	
Total separations (number)	 15,536 	 18,192 	 19,163 	 14,754 	 10,684 	 4,360 	 1,000 	 . . 	 83,689 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
Table A.12:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Western Australia, 2001–02
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–69	58.1	24.8	17.1	100.0	105	1.3	1.4	
70–74	63.6	21.5	14.9	100.0	275	3.0	3.3	
75–79	64.3	22.7	13.0	100.0	440	4.8	5.4	
Subtotal 65–79	63.3	22.6	14.1	100.0	820	3.1	3.5	
80–84	68.4	22.5	9.2	100.0	512	8.5	9.5	
85–89	69.2	21.8	9.0	100.0	513	13.7	15.2	
90+	66.1	25.1	8.8	100.0	319	23.3	25.9	
Subtotal 80+	68.2	22.8	9.0	100.0	1,344	12.1	13.4	
All	66.3	22.7	11.0	100.0	. .	5.8	6.4	
Total sep’s (N)	1,435	492	237	. .	2,164	            37,560	
Women								
65–69	65.9	24.2	9.9	100.0	91	1.3	1.4	
70–74	66.4	21.0	12.6	100.0	262	3.2	3.5	
75–79	65.1	22.3	12.6	100.0	637	6.9	7.7	
Subtotal 65–79	65.6	22.1	12.3	100.0	990	4.0	4.5	
80–84	65.8	21.4	12.8	100.0	1,052	13.4	14.9	
85–89	71.5	19.5	9.0	100.0	1,446	23.8	26.5	
90+	77.2	17.4	5.4	100.0	1,270	37.1	41.2	
Subtotal 80+	71.8	19.3	8.9	100.0	3,768	21.7	24.2	
All	70.5	19.9	9.6	100.0	. .	11.4	12.7	
Total sep’s (N)	3,355	947	456	. .	4,758	          41,832	
All								
65–69	61.7	24.5	13.8	100.0	196	1.3	1.4	
70–74	65.0	21.2	13.8	100.0	537	3.1	3.4	
75–79	64.8	22.5	12.7	100.0	1,077	5.9	6.6	
Subtotal 65–79	64.5	22.3	13.1	100.0	1,810	3.6	4.0	
80–84	66.6	21.7	11.6	100.0	1,564	11.3	12.6	
85–89	70.9	20.1	9.0	100.0	1,959	20.0	22.2	
90–94	74.4	18.8	6.8	100.0	1,247	31.7	35.3	
95+	76.9	19.6	3.5	100.0	342	39.6	44.0	
Subtotal 80+	70.9	20.2	8.9	100.0	5,112	18.0	20.0	
All	69.2	20.8	10.0	100.0	. .	8.7	9.7	
Total separations (number)	4,790	1,439	693	. .	6,922	            79,392	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
Table A.13:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Western Australia, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–69	            26 	            18 	            44 	1.4	:	1	
70–74	            59 	            41 	          100 	1.4	:	1	
75–79	          100 	            57 	          157 	1.8	:	1	
Subtotal 65–79	          185 	          116 	          301 	1.6	:	1	
80–84	          115 	            47 	          162 	2.4	:	1	
85–89	          112 	            46 	          158 	2.4	:	1	
90–94	            80 	            28 	           108 	2.9	:	1	
Subtotal 80+	          307 	          121 	          428 	2.5	:	1	
All	          492 	          237 	          729 	2.1	:	1	
Women							
65–69	            22 	              9 	            31 	2.4	:	1	
70–74	            55 	            33 	            88 	1.7	:	1	
75–79	          142 	            80 	          222 	1.8	:	1	
Subtotal 65–79	          219 	          122 	          341 	1.8	:	1	
80–84	          225 	          135 	          360 	1.7	:	1	
85–89	          282 	          130 	          412 	2.2	:	1	
90–94	        221	  69	 290	3.2	:	1	
Subtotal 80+	          728 	          334 	       1,062 	2.2	:	1	
All	          947 	          456 	       1,403 	2.1	:	1	
All							
65–69	            48 	            27 	            75 	1.8	:	1	
70–74	          114 	            74 	          188 	1.5	:	1	
75–79	          242 	          137 	          379 	1.8	:	1	
Subtotal 65–79	          404 	          238 	          642 	1.7	:	1	
80–84	          340 	          182 	          522 	1.9	:	1	
85–89	          394 	          176 	          570 	2.2	:	1	
90–94	          234 	            85 	          319 	2.8	:	1	
95+	            67 	            12 	            79 	5.6	:	1	
Subtotal 80+	       1,035 	          455 	       1,490 	2.3	:	1	
All	       1,439 	          693 	       2,132 	2.1	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.14:	Hospital separations for people aged 65+, by movement type, age and sex, South Australia, 2001–02 (unadjusted)
	Age at hospital admission			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	 3.3 	 10.9 	 18.1 	 23.3 	 25.7 	 15.3 	 3.3 	 100.0 	 1,729 	
To permanent RAC	 5.3 	 12.6 	 22.1 	 28.6 	 21.4 	 8.0 	 2.0 	 100.0 	 748 	
To respite RAC	 4.5 	 12.6 	 21.6 	 25.4 	 23.1 	 11.1 	 1.8 	 100.0 	 334 	
Subtotal	 4.0 	 11.6 	 19.6 	 25.0 	 24.3 	 12.9 	 2.8 	 100.0 	 2,811 	
To community/other	 20.4 	 24.5 	 25.6 	 17.5 	 9.3 	 2.4 	 0.4 	 100.0 	 38,551 	
Died in hospital	 12.0 	 17.5 	 22.1 	 22.3 	 18.4 	 6.3 	 1.5 	 100.0 	 2,451 	
All	 18.9 	 23.3 	 25.0 	 18.2 	 10.7 	 3.3 	 0.6 	 100.0 	. .	
Total separations (number)	 8,275 	 10,200 	 10,950 	 7,982 	 4,703 	 1,448 	 255 	 . . 	 43,813 	
Women	Row per cent		
To RAC			
Return to permanent RAC	1.8	4.5	13.2	23.5	29.5	21.6	5.9	100.0	 3,741 	
To permanent RAC	3.1	6.9	16.7	26.9	27.7	13.9	4.9	100.0	 1,110 	
To respite RAC	2.3	7.0	17.0	25.8	30.5	14.6	2.9	100.0	 659 	
Subtotal	2.1	5.3	14.4	24.5	29.2	19.2	5.4	100.0	 5,510 	
To community/other	16.2	20.8	24.2	20.5	12.9	4.5	0.8	100.0	 42,069 	
Died in hospital	8.3	13.3	19.0	22.2	21.4	12.4	3.5	100.0	 2,185 	
All	14.3	18.7	22.9	21.0	15.1	6.5	1.4	100.0	 . . 	
Total separations (number)	 7,126 	 9,315 	 11,394 	 10,471 	 7,524 	 3,225 	 709 	 . . 	 49,764 	
All	Row per cent		
To RAC			
Return to permanent RAC	2.3	6.5	14.8	23.5	28.3	19.6	5.1	100.0	 5,470 	
To permanent RAC	4.0	9.2	18.8	27.6	25.1	11.5	3.7	100.0	 1,858 	
To respite RAC	3.0	8.9	18.5	25.7	28.0	13.4	2.5	100.0	 993 	
Subtotal	2.8	7.4	16.1	24.7	27.5	17.1	4.5	100.0	 8,321 	
To community/other	18.2	22.6	24.9	19.1	11.2	3.5	0.6	100.0	 80,620 	
Died in hospital	10.3	15.5	20.6	22.2	19.8	9.1	2.4	100.0	 4,636 	
All	16.5	20.9	23.9	19.7	13.1	5.0	1.0	100.0	 . . 	
Total separations (number)	 15,401 	 19,515 	 22,344 	 18,453 	 12,227 	 4,673 	 964 	 . . 	 93,577 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	 Age is as at time of hospital admission.
Table A.15:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, South Australia, 2001–02 
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–69	50.9	35.7	13.4	100.0	          112 	1.4	1.6	
70–74	58.2	28.9	12.9	100.0	          325 	3.3	3.7	
75–79	56.9	30.0	13.1	100.0	          550 	5.3	5.9	
Subtotal 65–79	56.6	30.3	13.1	100.0	          987 	3.5	3.9	
80–84	57.4	30.5	12.1	100.0	          702 	9.4	10.5	
85–89	65.2	23.5	11.3	100.0	          682 	16.0	17.8	
90–94	73.2	16.6	10.2	100.0	          362 	28.0	31.1	
95+	73.1	19.2	7.7	100.0	            78 	35.6	39.6	
Subtotal 80+	64.1	24.6	11.2	100.0	       1,824 	13.8	15.4	
All	61.5	26.6	11.9	100.0	. .	6.8	7.6	
Total sep’s (N)	       1,729 	          748 	          334 	. .	       2,811 	              41,362	
Women								
65–69	58.1	29.1	12.8	100.0	          117 	1.7	1.9	
70–74	57.6	26.6	15.9	100.0	          290 	3.2	3.6	
75–79	62.5	23.4	14.2	100.0	          791 	7.2	8.0	
Subtotal 65–79	60.9	24.7	14.4	100.0	       1,198 	4.4	4.9	
80–84	65.3	22.1	12.6	100.0	       1,350 	13.5	15.0	
85–89	68.4	19.1	12.5	100.0	       1,610 	22.8	25.4	
90–94	76.3	14.6	9.1	100.0	       1,057 	35.8	39.8	
95+	75.3	18.3	6.4	100.0	          295 	46.6	51.8	
Subtotal 80+	69.9	18.9	11.3	100.0	       4,312 	20.9	23.2	
All	67.9	20.1	12.0	100.0	. .	11.6	12.9	
Total sep’s (N)	       3,741 	       1,110 	          659 	. .	       5,510 	            47,579	
All								
65–69	54.6	32.3	13.1	100.0	          229 	1.5	1.7	
70–74	57.9	27.8	14.3	100.0	          615 	3.3	3.6	
75–79	60.2	26.1	13.7	100.0	       1,341 	6.3	7.0	
Subtotal 65–79	58.9	27.2	13.8	100.0	       2,185 	4.0	4.4	
80–84	62.6	25.0	12.4	100.0	       2,052 	11.8	13.1	
85–89	67.5	20.4	12.1	100.0	       2,292 	20.3	22.5	
90–94	75.5	15.1	9.4	100.0	       1,419 	33.4	37.1	
95+	74.8	18.5	6.7	100.0	          373 	43.8	48.7	
Subtotal 80+	68.2	20.6	11.3	100.0	       6,136 	18.1	20.2	
All	65.7	22.3	11.9	100.0	. .	9.4	10.4	
Total separations (number)	       5,470 	       1,858 	          993 	. .	       8,321 	              88,941	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 
Table A.16:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, South Australia, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–69	40	15	55	2.7	:	1	
70–74	94	42	136	2.2	:	1	
75–79	165	72	237	2.3	:	1	
Subtotal 65–79	299	129	428	2.3	:	1	
80–84	214	85	299	2.5	:	1	
85–89	160	77	237	2.1	:	1	
90–94	60	37	97	1.6	:	1	
95+	15	6	21	2.5	:	1	
Subtotal 80+	449	205	654	2.2	:	1	
All	748	334	1,082	2.2	:	1	
Women							
65–69	34	15	49	2.3	:	1	
70–74	77	46	123	1.7	:	1	
75–79	185	112	297	1.7	:	1	
Subtotal 65–79	296	173	469	1.7	:	1	
80–84	299	170	469	1.8	:	1	
85–89	307	201	508	1.5	:	1	
90–94	154	96	250	1.6	:	1	
95+	54	19	73	2.8	:	1	
Subtotal 80+	814	486	1,300	1.7	:	1	
All	1,110	659	1,769	1.7	:	1	
All							
65–69	74	30	104	2.5	:	1	
70–74	171	88	259	1.9	:	1	
75–79	350	184	534	1.9	:	1	
Subtotal 65–79	595	302	897	2.0	:	1	
80–84	513	255	768	2.0	:	1	
85–89	467	278	745	1.7	:	1	
90–94	214	133	347	1.6	:	1	
95+	69	25	94	2.8	:	1	
Subtotal 80+	1,263	691	1,954	1.8	:	1	
All	1,858	993	2,851	1.9	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.17:	Hospital separations for people aged 65+, by movement type, age and sex, Tasmania, 2001–02 (unadjusted)
	Age at hospital admission		
Sex/movement type	65–79	80+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	29.9	70.1	100.0	271	
To permanent RAC	40.9	59.1	100.0	193	
To respite RAC	55.6	44.4	100.0	27	
Subtotal	35.6	64.4	100.0	491	
To community/other	72.6	27.4	100.0	10,943	
Died in hospital	57.5	42.5	100.0	562	
All	70.3	29.7	100.0	. .	
Total separations (number)	8,438	3,558	. .	11,996	
Women	Row per cent		
To RAC			
Return to permanent RAC	19.5	80.5	100.0	631	
To permanent RAC	22.9	77.1	100.0	293	
To respite RAC	28.9	71.1	100.0	38	
Subtotal	20.9	79.1	100.0	962	
To community/other	63.8	36.2	100.0	11,443	
Died in hospital	45.9	54.1	100.0	512	
All	59.9	40.1	100.0	 . .	
Total separations (number)	7,742	5,175	. .	12,917	
All	Row per cent		
To RAC			
Return to permanent RAC	22.6	77.4	100.0	902	
To permanent RAC	30.0	70.0	100.0	486	
To respite RAC	40.0	60.0	100.0	65	
Subtotal	25.9	74.1	100.0	1,453	
To community/other	68.1	31.9	100.0	22,386	
Died in hospital	52.0	48.0	100.0	1,074	
All	64.9	35.1	100.0	. .	
Total separations (number)	16,180	8,733	. .	24,913	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. Age groups have been combined due to small numbers.
Table A.18:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Tasmania, 2001–02 
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–79	46.3	45.1	8.6	100.0	175	2.2	2.4	
80+	60.1	36.1	3.8	100.0	316	9.5	10.6	
All	55.2	39.3	5.5	100.0	. .	4.3	4.8	
Total sep’s (N)	271	193	27	. .	491	              11,434	
Women								
65–79	61.2	33.3	5.5	100.0	201	2.7	3.0	
80+	66.8	29.7	3.5	100.0	761	15.5	17.3	
All	65.6	30.5	4.0	100.0	. .	7.8	8.6	
Total sep’s (N)	631	293	38	. .	962	             12,405	
All								
65–79	54.3	38.8	6.9	100.0	376	2.4	2.7	
80+	64.8	31.6	3.6	100.0	1,077	13.1	14.6	
All	62.1	33.4	4.5	100.0	. .	6.1	6.8	
Total separations (number)	902	486	65	. .	1,453	             23,839	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 

Table A.19:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Tasmania, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–79	79	15	94	5.3	:	1	
80+	114	12	126	9.5	:	1	
All	193	27	220	7.1	:	1	
Women							
65–79	67	11	78	6.1	:	1	
80+	226	27	253	8.4	:	1	
All	293	38	331	7.7	:	1	
All							
65–79	146	26	172	5.6	:	1	
80+	340	39	379	8.7	:	1	
All	486	65	551	7.5	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.20:	Hospital separations for people aged 65+, by movement type, age and sex, Australian Capital Territory, 2001–02 (unadjusted)
	Age at hospital admission		
Sex/movement type	65–79	80+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	32.5	67.5	100.0	157	
To permanent RAC	32.1	67.9	100.0	53	
To respite RAC	20.5	79.5	100.0	39	
Subtotal	30.5	69.5	100.0	249	
To community/other	75.9	24.1	100.0	5,144	
Died in hospital	58.1	41.9	100.0	303	
All	72.9	27.1	100.0	. .	
Total separations (number)	4,155	1,541	. .	5,696	
Women	Row per cent		
To RAC			
Return to permanent RAC	16.2	83.8	100.0	358	
To permanent RAC	24.4	75.6	100.0	82	
To respite RAC	32.1	67.9	100.0	56	
Subtotal	19.4	80.6	100.0	496	
To community/other	66.5	33.5	100.0	4,736	
Died in hospital	44.8	55.2	100.0	288	
All	61.2	38.8	100.0	. .	
Total separations (number)	3,376	2,144	. .	5,520	
All	Row per cent		
To RAC			
Return to permanent RAC	21.2	78.8	100.0	515	
To permanent RAC	27.4	72.6	100.0	135	
To respite RAC	27.4	72.6	100.0	95	
Subtotal	23.1	76.9	100.0	745	
To community/other	71.4	28.6	100.0	9,880	
Died in hospital	51.6	48.4	100.0	591	
All	67.1	32.9	100.0	. .	
Total separations (number)	7,531	3,685	. .	11,216	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. Age groups have been combined due to small numbers.
Table A.21:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Australian Capital Territory, 2001–02 
Sex/age	Returning to permanent RAC	To permanent RAC	To respite RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–79	67.1	22.4	10.5	100.0	76	1.9	2.1	
80+	61.3	20.8	17.9	100.0	173	12.2	13.6	
All	63.1	21.3	15.7	100.0	. .	4.6	5.1	
Total sep’s (N)	157	53	39	. .	249	              5,393	
Women								
65–79	60.4	20.8	18.8	100.0	96	3.0	3.3	
80+	75.0	15.5	9.5	100.0	400	20.2	22.4	
All	72.2	16.5	11.3	100.0	. .	9.5	10.5	
Total sep’s (N)	358	82	56	. .	496	            5,232	
All								
65–79	63.4	21.5	15.1	100.0	172	2.4	2.6	
80+	70.9	17.1	12.0	100.0	573	16.9	18.8	
Total	69.1	18.1	12.8	100.0	. .	7.0	7.8	
Total separations (number)	515	135	95	. .	745	             10,625	
Notes
1.	Table is based on linked hospital and RAC records. See notes Table 1.3 for information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 

Table A.22:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Australian Capital Territory, 2001–02 (unadjusted hospital separations)
Sex/age	To permanent RAC	To respite RAC	Total	Permanent : respite admissions	
Men	Number (unadjusted hospital separations)	Ratio	
65–79	17	8	25	2.1	:	1	
80+	36	31	67	1.2	:	1	
All	53	39	92	1.4	:	1	
Women							
65–79	20	18	38	1.1	:	1	
80+	62	38	100	1.6	:	1	
All	82	56	138	1.5	:	1	
All							
65–79	37	26	63	1.4	:	1	
80+	98	69	167	1.4	:	1	
All	135	95	230	1.4	:	1	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission. 
Table A.23:	Hospital separations for people aged 65+, by movement type, age and sex, Northern Territory, 2001–02 (unadjusted)
	Age at hospital admission		
Sex/movement type	65–79	80+	 Total	N	
Men	Row per cent		
To RAC			
Return to permanent RAC	         46.5 	         53.5 	            100.0 	              43 	
To permanent RAC	         65.2 	         34.8 	            100.0 	              23 	
To respite RAC	         53.0 	         47.0 	            100.0 	              66 	
Subtotal	         85.3 	         14.7 	            100.0 	         1,068 	
Died in hospital	         77.8 	         22.2 	            100.0 	              54 	
All	         83.2 	         16.8 	            100.0 	. . 	
Total separations (number)	          988 	          200 	. . 	         1,188 	
Women	Row per cent		
To RAC			
Return to permanent RAC	56.8	43.2	100.0	              37 	
To permanent RAC	70.6	29.4	100.0	              17 	
To respite RAC	61.1	38.9	100.0	              54 	
Subtotal	79.1	20.9	100.0	            860 	
Died in hospital	52.9	47.1	100.0	              51 	
All	76.7	23.3	100.0	. . 	
Total separations (number)	          740 	          225 	. . 	            965 	
All	Row per cent		
To RAC			
Return to permanent RAC	51.3	48.8	100.0	              80 	
To permanent RAC	67.5	32.5	100.0	              40 	
To respite RAC	56.7	43.3	100.0	            120 	
Subtotal	82.5	17.5	100.0	         1,928 	
Died in hospital	65.7	34.3	100.0	            105 	
All	80.3	19.7	100.0	. . 	
Total separations (number)	       1,728 	          425 	. . 	         2,153 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers. Links to admissions into permanent and respite RAC have been combined due to small numbers (55% of entries to RAC were permanent).
2.	Age is as at time of hospital admission. Age groups have been combined due to small numbers.
Table A.24:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Northern Territory, 2001–02 
Sex/age	Returning to permanent RAC	To RAC	Total	Unadjusted number	As per cent of all live hospital separations: estimated range	
Men	Row per cent	Est’d min %	Est’d max %	
65–79	57.1	42.9	100.0	35	3.7	4.1	
80+	74.2	25.8	100.0	31	16.5	18.3	
All	65.2	34.8	100.0	. .	5.8	6.5	
Total sep’s (N)	43	23	. .	66	                  1,134	
Women							
65–79	63.6	36.4	100.0	33	4.6	5.1	
80+	76.2	23.8	100.0	21	10.4	11.6	
All	68.5	31.5	100.0	. .	5.9	6.6	
Total sep’s (N)	37	17	. .	54	                914	
All							
65–79	60.3	39.7	100.0	68	4.1	4.6	
80+	75.0	25.0	100.0	52	13.4	14.9	
All	66.7	33.3	100.0	. .	5.9	6.5	
Total separations (number)	80	40	. .	120	               2,048	
Notes
1.	Table is based on linked hospital and RAC records. See notes to Table 1.3 For information on identification of transition groups. Estimated minimum per cent to RAC is based on unadjusted figures; estimated maximum per cent to RAC is derived by applying the maximum adjustment to all identified transition records (see Box 2.1).
2.	Age is as at time of hospital admission. 

Table A.25:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Northern Territory, 2001–02 
No data presented for the Northern Territory due to small numbers 
Table A.26:	Hospital separations for people aged 65+: mean length of stay, by movement type, sex and state/territory, 2001–02 (days) (unadjusted)
Sex/movement type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	
Men	Mean (days)	
Return to permanent RAC	8.2	8.3	7.8	8.7	7.3	7.5	7.5	7.3	8.0	
To permanent RAC	32.8	44.1	40.1	50.3	35.7	53.5	34.5	29.4	39.0	
To respite RAC	20.1	15.0	20.3	20.8	21.1	12.3	14.4	8.7	19.3	
To community/other	6.8	6.6	6.4	6.6	6.3	7.7	6.6	7.2	6.6	
Died in hospital	15.0	14.2	15.0	15.0	21.3	15.6	13.3	18.4	15.4	
All	8.0	7.8	7.5	7.8	7.8	8.8	7.3	7.9	7.8	
Total separations (number)	148,033	117,120	89,626	39,741	43,813	11,996	5,696	1,188	457,213	
Women	Mean (days)	
Return to permanent RAC	8.8	9.0	8.3	8.9	8.1	8.1	9.2	8.2	8.6	
To permanent RAC	32.2	40.4	43.3	43.4	34.4	45.5	35.9	47.1	37.7	
To respite RAC	19.5	19.2	19.2	20.8	20.5	10.6	16.8	6.7	19.5	
To community/other	7.8	7.8	7.2	7.3	7.0	9.0	7.7	8.0	7.6	
Died in hospital	21.8	15.3	17.0	22.1	26.3	16.0	14.1	13.2	19.4	
All	9.4	9.2	8.7	9.0	8.7	10.1	8.6	8.7	9.1	
Total separations (number)	160,682	126,981	90,171	43,948	49,764	12,917	5,520	965	490,948	
All	Mean (days)	
Return to permanent RAC	8.6	8.8	8.1	8.8	7.8	7.9	8.7	7.7	8.4	
To permanent RAC	32.5	41.7	42.0	45.7	34.9	48.7	35.4	38.2	38.2	
To respite RAC	19.7	17.7	19.6	20.8	20.7	11.3	15.8	8.0	19.5	
To community/other	7.3	7.2	6.8	7.0	6.7	8.4	7.1	7.6	7.1	
Died in hospital	18.2	14.7	15.9	18.5	23.7	15.8	13.7	15.9	17.3	
All	8.7	8.5	8.1	8.4	8.3	9.5	8.0	8.3	8.5	
Total separations (number)	308,715	244,101	179,797	83,689	93,577	24,913	11,216	2,153	948,161	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission.

Table A.27:	Hospital separations for people aged 65+: median of length of stay, by movement type, sex and state/territory, 2001–02 (days) (unadjusted)
Sex/movement type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	
Men	Median (days)	
Return to permanent RAC	6	5	5	5	5	5	6	5	5	
To permanent RAC	21	31	23	30	24	28	29	18	25	
To respite RAC	14	10	14	15	15	7	11	7	14	
To community/other	4	4	4	4	4	4	4	4	4	
Died in hospital	7	8	8	7	8	7	8	10	8	
All	4	4	4	4	4	5	4	5	4	
Total separations (number)	148,033	117,120	89,626	39,741	43,813	11,996	5,696	1,188	457,213	
Women	Median (days)	
Return to permanent RAC	6	6	6	6	5	6	7	6	6	
To permanent RAC	20	28	22	29	20	27	28	29	23	
To respite RAC	14	13	14	15	16	8	13	7	14	
To community/other	5	5	4	4	4	5	5	5	5	
Died in hospital	7	7	7	8	8	8	8	8	7	
All	5	5	5	5	5	5	6	5	5	
Total separations (number)	160,682	126,981	90,171	43,948	49,764	12,917	5,520	965	490,948	
All	Median (days)	
Return to permanent RAC	6	6	6	6	5	6	6	6	6	
To permanent RAC	20	29	22	29	22	28	28	27	24	
To respite RAC	14	12	14	15	16	7	12	7	14	
To community/other	4	4	4	4	4	5	5	5	4	
Died in hospital	7	8	7	8	8	7	8	9	7	
All	5	5	4	4	4	5	5	5	5	
Total separations (number)	308,715	244,101	179,797	83,689	93,577	24,913	11,216	2,153	948,161	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission.

Table A.28:	Hospital separations for people aged 65+: 90th percentile of length of stay, by movement type, sex and state/territory, 2001–02 (days) (unadjusted)
Sex/movement type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	
Men	90th percentile (days)	
Return to permanent RAC	17	19	16	20	16	16	14	17	17	
To permanent RAC	60	90	80	99	78	141	72	75	77	
To respite RAC	40	32	41	41	46	21	35	13	40	
To community/other	14	14	14	14	14	16	14	16	14	
Died in hospital	29	32	31	30	32	34	32	47	30	
All	17	17	16	16	15	18	16	18	16	
Total separations (number)	148,033	117,120	89,626	39,741	43,813	11,996	5,696	1,188	457,213	
Women	90th percentile (days)	
Return to permanent RAC	20	20	18	20	17	17	19	17	19	
To permanent RAC	55	82	70	84	65	82	81	123	69	
To respite RAC	40	40	40	46	38	23	30	13	40	
To community/other	17	17	15	16	15	18	16	17	16	
Died in hospital	30	32	30	35	35	35	34	35	32	
All	19	20	18	19	17	20	18	19	19	
Total separations (number)	160,682	126,981	90,171	43,948	49,764	12,917	5,520	965	490,948	
All	90th percentile (days)	
Return to permanent RAC	19	20	17	20	17	17	18	17	19	
To permanent RAC	57	84	75	89	70	99	81	108	73	
To respite RAC	40	38	40	44	42	21	34	13	40	
To community/other	15	16	15	15	14	17	15	17	15	
Died in hospital	29	32	30	32	33	35	32	41	31	
All	18	19	17	18	16	19	17	18	18	
Total separations (number)	308,715	244,101	179,797	83,689	93,577	24,913	11,216	2,153	948,161	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups. See technical note Box 3.1 on measuring length of stay.
2.	Age is as at time of hospital admission.
Table A.29:	RAC entries for people aged 65 and over, by movement type, sex and age, New South Wales, 2001–02 (unadjusted)
	Age at RAC admission/transfer			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.1	11.7	21.6	27.0	21.6	10.3	2.7	100.0	 2,806 	
From community into permanent RAC	5.7	10.9	18.5	26.7	24.9	11.2	2.2	100.0	 1,855 	
Transfer into permanent RAC	5.5	12.1	20.5	25.7	21.7	11.7	2.8	100.0	 2,403 	
Subtotal 	5.4	11.6	20.4	26.5	22.5	11.0	2.6	100.0	    7,064 	
Respite admissions										
From hospital to respite RAC 	6.7	12.2	25.2	26.4	18.1	9.5	2.0	100.0	 1,121 	
From community into respite RAC	7.9	13.1	22.5	25.6	20.5	9.0	1.5	100.0	 4,088 	
Transfer into respite RAC	10.7	<10.7	19.8	25.7	25.1	<10.7	<2.7	100.0	 187 	
Subtotal 	7.7	12.8	22.9	25.8	20.1	9.1	1.6	100.0	    5,396 	
All	6.4	12.1	21.5	26.2	21.5	10.2	2.2	100.0	. .	
Total admissions (number)	 795 	 1,509 	 2,682 	 3,262 	 2,677 	 1,266 	 269 	. .	 12,460 	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	2.9	7.2	14.3	24.5	28.5	17.3	5.1	100.0	 4,469 	
From community into permanent RAC	2.7	6.9	16.0	26.4	28.5	15.4	4.1	100.0	 4,111 	
Transfer into permanent RAC	1.9	6.6	14.7	25.2	28.2	17.8	5.6	100.0	 5,317 	
Subtotal 	2.4	6.9	15.0	25.4	28.4	17.0	5.0	100.0	  13,897 	
Respite admissions										
From hospital to respite RAC 	3.4	8.1	17.7	27.8	26.1	13.8	3.2	100.0	 2,158 	
From community into respite RAC	3.1	7.9	16.8	26.1	27.8	14.5	3.8	100.0	 7,463 	
Transfer into respite RAC	1.9	7.1	20.1	29.6	26.6	12.0	2.7	100.0	 368 	
Subtotal 	3.1	7.9	17.1	26.6	27.4	14.2	3.6	100.0	    9,989 	
All	2.7	7.3	15.9	25.9	28.0	15.8	4.4	100.0	. .	
Total admissions (number)	 653 	 1,750 	 3,787 	 6,178 	 6,683 	 3,779 	 1,056 	. .	 23,886 	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.7	8.9	17.1	25.5	25.9	14.6	4.2	100.0	 7,275 	
From community into permanent RAC	3.6	8.1	16.8	26.5	27.4	14.1	3.5	100.0	 5,966 	
Transfer into permanent RAC	3.0	8.3	16.5	25.4	26.2	15.9	4.7	100.0	 7,720 	
Subtotal 	3.4	8.5	16.8	25.7	26.4	14.9	4.2	100.0	  20,961 	
Respite admissions										
From hospital to respite RAC 	4.5	9.5	20.3	27.3	23.4	12.3	2.8	100.0	 3,279 	
From community into respite RAC	4.8	9.8	18.8	25.9	25.2	12.5	3.0	100.0	 11,551 	
Transfer into respite RAC	4.9	7.7	20.0	28.3	26.1	11.0	2.0	100.0	 555 	
Subtotal 	4.7	9.6	19.1	26.3	24.9	12.4	2.9	100.0	  15,385 	
All	4.0	9.0	17.8	26.0	25.8	13.9	3.6	100.0	. .	
Total admissions (number)	 1,448 	 3,259 	 6,469 	 9,440 	 9,360 	 5,045 	 1,325 	. .	 36,346 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	 Age is as at time of RAC admission/transfer.

Table A.30:	RAC entries for people aged 65 and over, by movement type, sex and age, Victoria, 
2001–02 (unadjusted)
	Age at RAC admission/transfer			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.3	10.9	19.9	26.0	24.1	11.6	2.2	100.0	 1,968 	
From community into permanent RAC	5.0	11.3	17.0	25.6	25.2	13.2	2.6	100.0	 1,474 	
Transfer into permanent RAC	5.8	11.4	17.9	22.2	24.6	14.6	3.5	100.0	 1,304 	
Subtotal 	5.3	11.2	18.4	24.9	24.6	12.9	2.7	100.0	    4,746 	
Respite admissions										
From hospital to respite RAC 	5.2	9.9	20.5	27.8	22.8	11.5	2.4	100.0	 425 	
From community into respite RAC	8.1	15.0	23.4	23.8	19.0	8.6	2.1	100.0	 3,251 	
Transfer into respite RAC	<8.8	9.7	26.5	23.9	20.4	<8.8	<4.4	100.0	 113 	
Subtotal 	7.7	14.3	23.1	24.3	19.5	8.9	2.2	100.0	    3,789 	
All	6.4	12.6	20.5	24.6	22.3	11.1	2.4	100.0	. .	
Total admissions (number)	 546 	 1,073 	 1,752 	 2,100 	 1,906 	 950 	 208 	. .	 8,535 	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	2.4	6.5	15.6	24.5	27.8	17.7	5.5	100.0	 3,502 	
From community into permanent RAC	2.1	5.6	14.8	26.2	29.7	17.1	4.5	100.0	 3,403 	
Transfer into permanent RAC	1.7	5.5	13.6	24.6	29.1	18.8	6.6	100.0	 2,993 	
Subtotal 	2.1	5.9	14.7	25.1	28.8	17.8	5.5	100.0	    9,898 	
Respite admissions										
From hospital to respite RAC 	2.7	7.1	17.1	28.9	30.9	10.4	3.0	100.0	 779 	
From community into respite RAC	3.7	8.5	16.0	25.8	27.7	14.1	4.3	100.0	 5,269 	
Transfer into respite RAC	<3.4	6.7	14.8	36.2	27.5	10.7	<3.4	100.0	 149 	
Subtotal 	3.5	8.3	16.1	26.4	28.1	13.6	4.0	100.0	    6,197 	
All	2.6	6.8	15.3	25.6	28.6	16.2	4.9	100.0	. .	
Total admissions (number)	 423 	 1,097 	 2,456 	 4,124 	 4,597 	 2,605 	 793 	. .	 16,095 	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.4	8.1	17.1	25.1	26.5	15.5	4.3	100.0	 5,470 	
From community into permanent RAC	3.0	7.4	15.5	26.0	28.3	16.0	3.9	100.0	 4,877 	
Transfer into permanent RAC	3.0	7.3	14.9	23.9	27.8	17.5	5.6	100.0	 4,297 	
Subtotal 	3.1	7.6	15.9	25.0	27.5	16.2	4.6	100.0	  14,644 	
Respite admissions										
From hospital to respite RAC 	3.6	8.1	18.3	28.5	28.1	10.8	2.7	100.0	 1,204 	
From community into respite RAC	5.3	11.0	18.8	25.1	24.4	12.0	3.4	100.0	 8,520 	
Transfer into respite RAC	5.0	8.0	19.8	30.9	24.4	9.5	2.3	100.0	 262 	
Subtotal 	5.1	10.6	18.8	25.6	24.8	11.8	3.3	100.0	    9,986 	
All	3.9	8.8	17.1	25.3	26.4	14.4	4.1	100.0	. .	
Total admissions (number)	 969 	 2,170 	 4,208 	 6,224 	 6,503 	 3,555 	 1,001 	. .	 24,630 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer.
Table A.31:	RAC entries for people aged 65 and over, by movement type, sex and age, Queensland, 2001–02 (unadjusted)
	Age at RAC admission/transfer			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.2	11.5	21.6	26.1	22.7	10.8	2.1	100.0	 1,373 	
From community into permanent RAC	5.6	10.6	19.0	24.0	25.4	12.1	3.2	100.0	 1,046 	
Transfer into permanent RAC	5.4	8.3	17.9	25.4	27.7	13.2	2.3	100.0	 1,041 	
Subtotal 	5.4	10.3	19.7	25.2	25.0	11.9	2.5	100.0	    3,460 	
Respite admissions										
From hospital to respite RAC 	5.3	11.7	19.7	29.5	22.0	9.8	1.9	100.0	 528 	
From community into respite RAC	6.9	12.3	22.5	25.2	22.2	9.1	1.8	100.0	 2,124 	
Transfer into respite RAC	<5.6	14.4	23.3	20.0	32.2	6.7	<5.6	100.0	 90 	
Subtotal 	6.5	12.3	22.0	25.9	22.5	9.2	1.8	100.0	2,742 	
All	5.9	11.1	20.7	25.5	23.9	10.7	2.2	100.0	. .	
Total admissions (number)	 364 	 691 	 1,283 	 1,583 	 1,482 	 664 	 135 	. .	 6,202 	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	2.9	7.8	14.8	27.0	27.3	16.0	4.2	100.0	 2,069 	
From community into permanent RAC	2.5	7.1	15.5	28.0	28.1	15.3	3.5	100.0	 2,378 	
Transfer into permanent RAC	2.1	6.6	14.9	23.8	29.8	17.4	5.4	100.0	 2,177 	
Subtotal 	2.5	7.1	15.1	26.3	28.4	16.2	4.3	100.0	    6,624 	
Respite admissions										
From hospital to respite RAC 	2.9	9.6	18.9	29.7	23.7	11.8	3.4	100.0	 873 	
From community into respite RAC	3.2	7.2	14.7	25.4	30.2	16.4	2.9	100.0	 3,451 	
Transfer into respite RAC	<6.2	8.6	11.7	28.4	24.7	16.7	<6.2	100.0	 162 	
Subtotal 	3.2	7.7	15.4	26.4	28.7	15.5	3.0	100.0	4,486 	
All	2.8	7.4	15.2	26.3	28.5	15.9	3.8	100.0	. .	
Total admissions (number)	 309 	 820 	 1,689 	 2,926 	 3,171 	 1,772 	 423 	. .	 11,110 	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.8	9.3	17.5	26.6	25.5	13.9	3.4	100.0	 3,442 	
From community into permanent RAC	3.4	8.1	16.6	26.8	27.3	14.4	3.4	100.0	 3,424 	
Transfer into permanent RAC	3.2	7.1	15.8	24.3	29.1	16.0	4.4	100.0	 3,218 	
Subtotal 	3.5	8.2	16.7	25.9	27.3	14.7	3.7	100.0	  10,084 	
Respite admissions										
From hospital to respite RAC 	3.8	10.4	19.2	29.6	23.1	11.1	2.9	100.0	 1,401 	
From community into respite RAC	4.6	9.1	17.7	25.4	27.1	13.7	2.5	100.0	 5,575 	
Transfer into respite RAC	4.8	10.7	15.9	25.4	27.4	13.1	2.8	100.0	 252 	
Subtotal 	4.4	9.4	17.9	26.2	26.3	13.1	2.6	100.0	    7,228 	
All	3.9	8.7	17.2	26.0	26.9	14.1	3.2	100.0	. .	
Total admissions (number)	 673	 1,511	 2,972	 4,509	 4,653	 2,436	 558	. .	 17,312	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer.
Table A.32:	RAC entries for people aged 65+, by movement type, age and sex, Western Australia, 2001–02 (unadjusted)
	Age at RAC admission/transfer			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.1	12.4	20.1	23.1	22.9	13.4	3.0	100.0	 493 	
From community into permanent RAC	5.6	13.7	18.4	21.6	23.3	14.3	3.2	100.0	 533 	
Transfer into permanent RAC	6.0	11.0	21.2	21.5	24.8	11.7	3.8	100.0	 419 	
Subtotal 	5.5	12.5	19.8	22.1	23.6	13.2	3.3	100.0	    1,445 	
Respite admissions										
From hospital to respite RAC 	7.6	16.9	24.5	19.0	20.3	<12.7	<2.1	100.0	 237 	
From community into respite RAC	8.4	15.8	21.5	26.6	16.5	9.5	1.7	100.0	 896 	
Transfer into respite RAC	5.9	17.6	17.6	35.3	11.8	11.8	0.0	100.0	 34 	
Subtotal 	8.1	16.1	22.0	25.3	17.1	9.9	1.5	100.0	    1,167 	
All	6.7	14.1	20.8	23.5	20.7	11.7	2.5	100.0	. .	
Total admissions (number)	 175 	 368 	 543 	 614 	 541 	 306 	 65 	. .	 2,612 	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	2.4	5.6	14.7	23.8	29.7	18.2	5.7	100.0	 947 	
From community into permanent RAC	2.2	5.7	13.6	24.6	29.2	19.4	5.5	100.0	 1,209 	
Transfer into permanent RAC	2.5	5.5	13.4	23.2	32.5	18.9	4.0	100.0	 1,138 	
Subtotal 	2.4	5.6	13.8	23.9	30.5	18.9	5.0	100.0	    3,294 	
Respite admissions										
From hospital to respite RAC 	<4.4	7.2	17.3	29.6	28.5	13.2	<4.4	100.0	 456 	
From community into respite RAC	6.3	7.6	14.8	24.9	30.3	13.7	2.4	100.0	 1,494 	
Transfer into respite RAC	<6.8	6.8	15.1	31.5	31.5	12.3	<6.8	100.0	 73 	
Subtotal 	5.2	7.5	15.4	26.2	30.0	13.5	2.3	100.0	    2,023 	
All	3.4	6.3	14.4	24.8	30.3	16.8	4.0	100.0	. .	
Total admissions (number)	 183 	 336 	 766 	 1,316 	 1,610 	 895 	 211 	. .	 5,317 	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.3	7.9	16.5	23.5	27.4	16.5	4.8	100.0	 1,440 	
From community into permanent RAC	3.2	8.2	15.0	23.7	27.4	17.8	4.8	100.0	 1,742 	
Transfer into permanent RAC	3.5	7.0	15.5	22.7	30.4	17.0	3.9	100.0	 1,557 	
Subtotal 	3.3	7.7	15.6	23.3	28.4	17.1	4.5	100.0	    4,739 	
Respite admissions										
From hospital to respite RAC 	3.9	10.5	19.8	26.0	25.7	12.4	1.7	100.0	 693 	
From community into respite RAC	7.1	10.7	17.3	25.5	25.1	12.1	2.1	100.0	 2,390 	
Transfer into respite RAC	<4.7	10.3	15.9	32.7	25.2	12.1	<4.7	100.0	 107 	
Subtotal 	6.3	10.6	17.8	25.9	25.3	12.2	2.0	100.0	    3,190 	
All	4.5	8.9	16.5	24.3	27.1	15.1	3.5	100.0	. .	
Total admissions (number)	 358 	 704 	 1,309 	 1,930 	 2,151 	 1,201 	 276 	. .	 7,929 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer.
Table A.33: RAC entries for people aged 65+, by movement type, age and sex, South Australia, 
2001–02 (unadjusted)
	Age at RAC admission/transfer			
Sex/movement type	65–69	70–74	75–79	80–84	85–89	90–94	95+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	5.2	12.2	22.1	28.6	21.6	8.2	2.0	100.0	 745 	
From community into permanent RAC	1.9	9.9	16.3	25.4	30.7	13.3	2.5	100.0	 473 	
Transfer into permanent RAC	4.0	9.5	19.4	27.8	22.8	13.6	2.9	100.0	 623 	
Subtotal 	4.0	10.7	19.7	27.5	24.3	11.4	2.4	100.0	    1,841 	
Respite admissions										
From hospital to respite RAC 	4.5	12.5	21.5	25.1	23.6	10.7	2.1	100.0	 335 	
From community into respite RAC	6.5	13.2	20.0	29.3	18.3	10.8	1.8	100.0	 1,103 	
Transfer into respite RAC	<9.4	<9.4	28.3	22.6	20.8	11.3	<9.4	100.0	 53 	
Subtotal 	6.0	12.9	20.7	28.1	19.6	10.8	1.9	100.0	    1,491 	
All	4.9	11.7	20.1	27.8	22.2	11.1	2.2	100.0	. .	
Total admissions (number)	 163 	 389 	 671 	 925 	 740 	 370 	 74 	. .	 3,332 	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.0	6.8	16.2	26.7	28.3	14.0	5.0	100.0	 1,113 	
From community into permanent RAC	2.1	6.2	14.5	27.2	30.5	15.2	4.1	100.0	 1,025 	
Transfer into permanent RAC	1.8	5.6	13.3	23.5	31.5	18.0	6.2	100.0	 1,491 	
Subtotal 	2.3	6.2	14.5	25.5	30.3	16.0	5.3	100.0	    3,629 	
Respite admissions										
From hospital to respite RAC 	2.6	8.8	15.8	23.9	32.7	12.8	3.5	100.0	 1,587 	
From community into respite RAC	2.3	6.7	16.6	26.2	30.6	14.8	2.9	100.0	 657 	
Transfer into respite RAC	<6.4	9.0	20.5	17.9	33.3	15.4	<6.4	100.0	 78 	
Subtotal 	2.5	8.2	16.1	24.3	32.1	13.4	3.3	100.0	    2,322 	
All	2.4	7.0	15.2	25.1	31.0	15.0	4.5	100.0	. .	
Total admissions (number)	 140 	 414 	 902 	 1,492 	 1,844 	 892 	 267 	. .	 5,951 	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	3.9	9.0	18.6	27.4	25.6	11.7	3.8	100.0	 1,858 	
From community into permanent RAC	2.1	7.4	15.1	26.6	30.6	14.6	3.6	100.0	 1,498 	
Transfer into permanent RAC	2.5	6.8	15.1	24.8	28.9	16.7	5.3	100.0	 2,114 	
Subtotal 	2.8	7.7	16.3	26.2	28.3	14.4	4.3	100.0	    5,470 	
Respite admissions										
From hospital to respite RAC 	3.0	8.7	18.2	25.8	28.2	13.4	2.6	100.0	 992 	
From community into respite RAC	4.2	10.6	17.5	26.1	26.8	12.0	2.8	100.0	 2,690 	
Transfer into respite RAC	<3.8	8.4	23.7	19.8	28.2	13.7	<3.8	100.0	 131 	
Subtotal 	3.9	10.0	17.9	25.8	27.2	12.4	2.8	100.0	    3,813 	
All	3.3	8.7	16.9	26.0	27.8	13.6	3.7	100.0	. .	
Total admissions (number)	 303 	 803 	 1,573 	 2,417 	 2,584 	 1,262 	 341 	. .	 9,283 	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer.
Table A.34:	RAC entries for people aged 65+, by movement type, age and sex, Tasmania, 2001–02 (unadjusted)
	Age at RAC admission/transfer		
Sex/movement type	65–79	80+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	40.9	59.1	100.0	193	
From community into permanent RAC	34.1	65.9	100.0	170	
Transfer into permanent RAC	21.5	78.5	100.0	79	
Subtotal 	34.8	65.2	100.0	442	
Respite admissions					
From hospital to respite RAC 	n.p.	n.p.	100.0	27	
From community into respite RAC	42.7	57.3	100.0	499	
Transfer into respite RAC	n.p.	n.p.	100.0	8	
Subtotal 	43.1	56.9	100.0	534	
All	39.3	60.7	100.0	 . .	
Total admissions (number)	384	592	 . .	976	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	22.8	77.2	100.0	294	
From community into permanent RAC	20.9	79.1	100.0	359	
Transfer into permanent RAC	21.5	78.5	100.0	242	
Subtotal 	21.7	78.3	100.0	895	
Respite admissions					
From hospital to respite RAC 	<38.5	>61.5	100.0	39	
From community into respite RAC	30.3	69.7	100.0	870	
Transfer into respite RAC	n.p.	n.p.	100.0	28	
Subtotal 	29.9	70.1	100.0	937	
All	25.9	74.1	100.0	 . .	
Total admissions (number)	474	1,358	 . .	1,832	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	30.0	70.0	100.0	487	
From community into permanent RAC	25.1	74.9	100.0	529	
Transfer into permanent RAC	21.5	78.5	100.0	321	
Subtotal 	26.0	74.0	100.0	1,337	
Respite admissions					
From hospital to respite RAC 	39.4	60.6	100.0	66	
From community into respite RAC	34.8	65.2	100.0	1,369	
Transfer into respite RAC	19.4	80.6	100.0	36	
Subtotal 	34.7	65.3	100.0	1,471	
All	30.6	69.4	100.0	 . .	
Total admissions (number)	858	1,950	 . .	2,808	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on 
identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer. Age groups have been combined due to small numbers.

Table A.35:	RAC entries for people aged 65+, by movement type, age and sex, 
Australian Capital Territory, 2001–02 (unadjusted)
	Age at RAC admission/transfer		
Sex/movement type	65–79	80+	 Total	N	
Men	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	36.7	63.3	100.0	49	
From community into permanent RAC	29.4	70.6	100.0	51	
Transfer into permanent RAC	34.6	65.4	100.0	78	
Subtotal 	33.7	66.3	100.0	178	
Respite admissions					
From hospital to respite RAC 	<28.6	>71.4	100.0	35	
From community into respite RAC	40.4	59.6	100.0	230	
Transfer into respite RAC	n.p.	n.p.	100.0	13	
Subtotal 	37.1	62.9	100.0	278	
All	35.7	64.3	100.0	. .	
Total admissions (number)	163	293	. .	456	
Women	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	21.4	78.6	100.0	84	
From community into permanent RAC	35.4	64.6	100.0	130	
Transfer into permanent RAC	22.2	77.8	100.0	167	
Subtotal 	26.5	73.5	100.0	381	
Respite admissions					
From hospital to respite RAC 	<35.7	>64.3	100.0	56	
From community into respite RAC	27.0	73.0	100.0	389	
Transfer into respite RAC	n.p.	n.p.	100.0	17	
Subtotal 	27.9	72.1	100.0	462	
All	27.3	72.7	100.0	. .	
Total admissions (number)	230	613	. .	843	
All	Row per cent		
Permanent admissions			
From hospital to permanent RAC 	27.1	72.9	100.0	133	
From community into permanent RAC	33.7	66.3	100.0	181	
Transfer into permanent RAC	26.1	73.9	100.0	245	
Subtotal 	28.8	71.2	100.0	559	
Respite admissions					
From hospital to respite RAC 	26.4	73.6	100.0	91	
From community into respite RAC	32.0	68.0	100.0	619	
Transfer into respite RAC	33.3	66.7	100.0	30	
Subtotal 	31.4	68.6	100.0	740	
All	30.3	69.7	100.0	. .	
Total admissions (number)	393	906	. .	1,299	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on 
identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC admission/transfer. Age groups have been combined due to small numbers.

Table A.36:	RAC entries for people aged 65+, by movement type, age and sex, Northern Territory, 2001–02 (unadjusted)
	Age at RAC admission/transfer		
Sex/movement type	65–79	80+	 Total	N	
Men	Row per cent		
From hospital to RAC 	61.9	38.1	100.0	21	
Transfer within RAC	46.7	53.3	100.0	23	
From community into permanent RAC	45.5	54.5	100.0	22	
From community into respite RAC	62.3	37.7	100.0	69	
All	57.5	42.5	100.0	. .	
Total admissions (number)	73	54	. .	135	
Women	Row per cent		
From hospital to RAC 	70.6	29.4	100.0	17	
Transfer within RAC	39.1	60.9	100.0	15	
From community into permanent RAC	50.0	50.0	100.0	22	
From community into respite RAC	48.6	51.4	100.0	111	
All	49.7	50.3	100.0	. .	
Total admissions (number)	86	87	. .	165	
All	Row per cent		
From hospital to RAC 	65.8	34.2	100.0	38	
Transfer within RAC	42.1	57.9	100.0	38	
From community into permanent RAC	47.7	52.3	100.0	44	
From community into respite RAC	53.9	46.1	100.0	180	
All	53.0	47.0	100.0	. .	
Total admissions (number)	159	141	. .	300	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.Respite and permanent admissions from hospital have been combined due to small numbers. Transfers into permanent and respite RAC have been combined due to small numbers.
2.	Age is as at time of RAC admission/transfer. Age groups have been combined due to small numbers.

Table A.37:	Hospital separations for people aged 65+, by movement type and hospital care type, by state/territory, 2001–02 (unadjusted)
State/territory
hospital care type	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/
other	Died in hospital	All	N	
New South Wales	Column per cent		
Acute	91.2	55.9	67.8	92.4	78.2	90.4	278,985	
Rehabilitation	6.2	13.7	17.7	5.5	1.4	5.6	17,353	
Palliative	0.4	2.7	0.8	0.6	17.2	1.6	4,837	
GEM	0.3	1.6	1.2	0.4	0.3	0.4	1,200	
Psychogeriatric	0.8	1.1	1.0	0.2	0.1	0.2	734	
Maintenance	1.0	24.8	11.4	0.9	2.9	1.7	5,246	
Other	0.1	0.2	0.2	0.1	—	0.1	360	
Total	100.0	100.0	100.0	100.0	100.0	100.0	 . .	
Total separations (number)	15,836	7,279	3,265	264,461	17,874	 . .	308,715	
Victoria			
Acute	90.5	43.8	77.0	91.0	76.7	89.0	217,364	
Rehabilitation	4.4	6.8	8.8	6.1	0.8	5.8	14,069	
Palliative	0.3	1.1	0.6	0.4	16.8	1.3	3,227	
GEM	4.5	27.5	8.3	2.3	4.0	3.1	7,506	
Psychogeriatric	—	—	—	—	—	—	—	
Maintenance	—	—	—	—	—	—	—	
Other	0.2	20.8	5.3	0.2	1.7	0.8	1,935	
Total	100.0	100.0	100.0	100.0	100.0	100.0	 . .	
Total separations (number)	10,639	5,443	1,203	213,076	13,740	 . .	244,101	
Queensland								
Acute	95.7	45.8	76.7	95.6	77.8	93.6	168,369	
Rehabilitation	2.7	8.0	6.6	2.4	0.9	2.4	4,403	
Palliative	0.3	2.1	1.4	0.7	16.5	1.5	2,662	
GEM	0.2	1.0	0.5	0.1	0.2	0.1	236	
Psychogeriatric	0.2	0.7	<0.4	0.1	0.1	0.1	152	
Maintenance	0.7	42.3	14.0	1.0	4.5	2.1	3,745	
Other	0.1	0.2	<0.7	0.1	0.1	0.1	230	
Total	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	10,088	3,455	1,410	155,796	9,048	 . .	179,797	
							(continued)
	
Table A.37 (continued):	Hospital separations for people aged 65+, by movement type and hospital care type, by state/territory, 2001–02 (unadjusted)
State/territory
hospital care type	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/
other	Died in hospital	All	N	
Western Australia	Column per cent		
Acute	90.9	41.6	64.8	93.8	71.5	91.4	76,453	
Rehabilitation	6.3	21.8	18.8	3.5	2.8	4.1	3,404	
Palliative	0.6	1.3	2.5	1.0	21.9	2.0	1,695	
GEM	—	—	—	—	—	—	7	
Psychogeriatric	1.7	5.5	2.2	0.4	0.5	0.6	515	
Maintenance	0.5	29.9	11.8	1.3	3.4	1.9	1,615	
Other	—	—	—	—	—	—	—	
Total	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total separations (number)	4,790	1,439	693	72,470	4,297	. .	83,689	
South Australia			
Acute	97.0	70.2	85.6	94.0	83.2	93.1	87,103	
Rehabilitation	2.5	6.5	6.8	3.7	0.5	3.6	3,323	
Palliative	0.1	1.3	<0.5	0.3	12.0	0.9	839	
GEM	—	0.4	<0.5	—	—	—	32	
Psychogeriatric	—	<0.3	<0.5	0.0	0.4	—	36	
Maintenance	0.3	21.4	6.5	0.3	3.8	1.0	905	
Other	—	<0.3	<0.5	1.6	0.1	1.4	1,338	
Total	100.0	100.0	100.0	100.0	100.0	100.0	 . .	
Total separations (number)	5,470	1,858	993	80,619	4,636	. .	93,576	
Tasmania								
Acute	97.8	48.5	87.5	97.1	80.4	95.1	17,878	
Rehabilitation	1.5	4.8	—	1.9	1.1	1.9	360	
Palliative	<0.7	<1.2	—	0.3	12.7	1.0	192	
GEM	—	<1.2	—	—	<0.5	—	<5	
Psychogeriatric	—	—	—	—	<0.5	—	<5	
Maintenance	<0.7	45.7	12.5	0.6	5.5	2.0	372	
Other	—	—	—	—	—	—	—	
Total	100.0	100.0	100.0	100.0	100.0	100.0	 . .	
Total separations (number)	734	433	56	16,514	1,069	. .	18,806	
							(continued)
	
Table A.37 (continued):	Hospital separations for people aged 65+, by movement type and hospital care type, by state/territory, 2001–02 (unadjusted)
State/territory
hospital care type	Returning to permanent RAC	To permanent RAC	To respite RAC	To community/
other	Died in hospital	All	N	
Australian Capital Territory	Column per cent		
Acute	97.1	63.0	92.6	97.3	68.4	95.4	10,695	
Rehabilitation	2.1	<3.7	<5.3	1.7	0.8	1.7	190	
Palliative	<1.0	—	—	0.4	29.6	1.9	217	
GEM	—	<7.4	<5.3	0.1	<0.8	0.2	24	
Psychogeriatric	—	—	—	—	—	—	<5	
Maintenance	<1.0	28.9	<5.3	0.4	0.8	0.8	88	
Other	—	—	—	—	<0.8	—	<5	
Total	100.0	100.0	100.0	100.0	100.0	100.0	 . .	
Total separations (number)	515	135	95	9,880	591	 . .	11,216	
Northern Territory			
Acute	100.0	54.5	94.4	97.1	96.2	96.7	2,083	
Rehabilitation	—	n.p.	n.p.	<0.3	—	0.9	19	
Palliative	—	—	—	<0.3	<4.8	0.4	9	
GEM	—	—	—	—	—	—	—	
Psychogeriatric	—	—	—	—	—	—	—	
Maintenance	—	n.p.	n.p.	1.1	<4.8	1.5	33	
Other	—	—	—	0.5	—	0.4	9	
Total	100.0	100.0	100.0	100.0	100.0	100.0	..	
Total separations (number)	80	22	18	1,928	105	..	2,153	
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	Newborn care types, organ procurement and hospital boarders were omitted from the tables (1 case).
4.	6,107 records with unknown care type were omitted from the table. All of these records related to separations from Tasmanian hospitals; 6,095 were from private hospitals.
5.	See Table 3.7 for national figures.

Table A.38:	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)
Movement type/principal diagnosis 
ICD-10-AM Ed. 2 chapter(a)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
Return to permanent RAC	Column per cent			
Diseases of the circulatory system 
(I00–I99)	15.5	15.2	17.3	15.4	15.6	16.0	13.0	11.3	15.8	7,629	
Diseases of the respiratory system 
(J00–J99)	14.1	13.1	12.4	12.7	13.4	11.0	14.0	17.5	13.3	6,403	
Injury, poisoning and other consequences of external causes (S00–T98)	13.5	12.6	13.0	12.4	12.1	17.6	16.1	16.3	13.0	6,305	
Diseases of the digestive system 
(K00–K93)	9.2	8.9	10.2	10.0	9.7	9.3	10.3	22.5	9.5	4,597	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	7.0	8.4	7.7	7.4	7.8	5.0	6.4	6.3	7.5	3,638	
Factors influencing health status and contact with health services 
(excluding Z75.1)	8.1	7.3	4.9	7.6	5.1	3.2	2.9	<6.3	6.7	3,249	
Diseases of the genitourinary system 
(N00–N99)	5.6	5.7	6.4	6.9	6.7	5.5	8.3	<6.3	6.1	2,930	
Neoplasms (tumours and cancers) 
(C00–D48)	4.9	5.8	6.4	5.5	6.3	7.6	4.9	<6.3	5.7	2,746	
All other diagnoses	22.1	22.9	21.6	22.2	23.3	24.7	24.1	21.3	22.4	10,823	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
	Diagnosis rank			
Diseases of the circulatory system 
(I00–I99)	1	1	1	1	1	2	3	4	1	7,629	
Diseases of the respiratory system 
(J00–J99)	2	2	3	2	2	3	2	2	2	6,403	
Injury, poisoning and other consequences of external causes (S00–T98)	3	3	2	3	3	1	1	3	3	6,305	
Diseases of the digestive system 
(K00–K93)	4	4	4	4	4	4	4	1	4	4,597	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	6	5	5	6	5	7	6	5	5	3,638	
Factors influencing health status and contact with health services 
(excluding Z75.1)	5	6	8	5	8	12	12	n.p.	6	3,249	
Diseases of the genitourinary system 
(N00–N99)	7	8	7	7	6	6	5	n.p.	7	2,930	
Neoplasms (tumours and cancers) 
(C00–D48)	8	7	6	8	7	5	7	n.p.	8	2,746	
Total separations (number)	15,836	10,639	10,088	4,790	5,470	902	515	80	. .	48,320	
									(continued)
	
Table A.38 (cont’d):	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)
Movement type/principal diagnosis 
ICD-10-AM Ed. 2 chapter(a)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
To permanent RAC	Column per cent		
Awaiting admission elsewhere (Z75.1)	15.7	19.5	35.2	17.5	19.3	41.8	7.4	31.8	21.1	4,247	
Factors influencing health status and contact with health services (excluding Z75.1)	20.0	14.8	10.1	27.8	13.6	11.5	<3.7	n.p.	16.5	3,323	
Diseases of the circulatory system (I00–I99)	12.2	12.8	10.3	9.8	14.1	8.6	29.6	n.p.	12.1	2,431	
Mental and behavioural disorders (F00–F99)	8.9	9.7	7.9	9.5	9.4	8.0	4.4	—	9.0	1,808	
Injury, poisoning and other consequences of external causes (S00–T98)	8.2	9.4	6.6	6.0	8.1	4.9	19.3	—	8.1	1,623	
Diseases of the nervous system (G00–G99)	5.0	5.7	5.3	7.4	5.8	4.7	<3.7	n.p.	5.5	1,099	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	4.8	7.5	4.2	4.0	4.6	3.3	6.7	n.p.	5.3	1,073	
Diseases of the respiratory system (J00–J99)	6.3	4.9	4.1	4.2	5.2	3.7	9.6	—	5.3	1,057	
Neoplasms (tumours and cancers) 
(C00–D48)	5.7	3.2	4.9	2.4	8.0	2.5	6.7	n.p.	4.8	958	
Diseases of the genitourinary system 
(N00–N99)	3.2	2.9	2.3	2.9	3.1	1.9	5.2	n.p.	2.9	588	
All other diagnoses	10.0	9.7	9.1	8.4	8.9	9.1	6.7	n.p.	9.5	1,910	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
	Diagnosis rank		
Awaiting admission elsewhere (Z75.1)	2	1	1	2	1	1	4	1	1	4,247	
Factors influencing health status and contact with health services (excluding Z75.1)	1	2	3	1	3	2	n.p.	n.p.	2	3,323	
Diseases of the circulatory system (I00–I99)	3	3	2	3	2	3	1	n.p.	3	2,431	
Mental and behavioural disorders (F00–F99)	4	4	4	4	4	4	8	—	4	1,808	
Injury, poisoning and other consequences of external causes (S00–T98)	5	5	5	6	5	5	2	—	5	1,623	
Diseases of the nervous system (G00–G99)	8	7	6	5	7	6	n.p.	n.p.	6	1,099	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	9	6	8	8	9	8	5	n.p.	7	1,073	
Diseases of the respiratory system (J00–J99)	6	8	9	7	8	7	3	—	8	1,057	
Neoplasms (tumours and cancers) 
(C00–D48)	7	9	7	11	6	10	5	n.p.	9	958	
Diseases of the genitourinary system 
(N00–N99)	10	11	11	10	11	12	7	n.p.	10	588	
Total separations (number)	7,279	5,443	3,455	1,439	1,858	486	135	22	. .	20,117	
									(continued)	
Table A.38 (cont’d):	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)
Movement type/principal diagnosis 
ICD-10-AM Ed. 2 chapter(a)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
To respite RAC	Column per cent		
Factors influencing health status and contact with health services (excluding Z75.1)	23.8	19.6	11.5	23.4	19.3	10.8	6.3	n.p.	19.9	1,543	
Diseases of the circulatory system (I00–I99)	11.2	12.2	13.2	12.0	14.1	16.9	16.8	n.p.	12.3	950	
Injury, poisoning and other consequences of external causes (S00–T98)	11.7	10.6	13.2	7.9	10.7	7.7	9.5	n.p.	11.3	871	
Mental and behavioural disorders (F00–F99)	7.2	7.5	7.7	8.1	8.2	10.8	6.3	n.p.	7.6	585	
Diseases of the respiratory system 
(J00–J99)	7.3	8.8	6.9	7.5	6.7	n.p.	17.9	n.p.	7.5	583	
Awaiting admission elsewhere (Z75.1)	6.4	5.5	9.4	5.2	5.1	n.p.	—	n.p.	6.5	500	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	5.5	7.8	7.1	7.9	6.1	n.p.	n.p.	n.p.	6.4	498	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	5.6	5.2	6.5	5.5	4.9	n.p.	10.5	n.p.	5.7	438	
Neoplasms (tumours and cancers) 
(C00–D48)	4.5	5.1	5.4	6.5	6.2	n.p.	5.3	—	5.1	397	
Diseases of the nervous system (G00–G99)	4.2	3.8	5.6	4.2	5.0	n.p.	n.p.	—	4.5	345	
Diseases of the digestive system (K00–K93)	3.8	3.7	3.8	3.0	3.4	7.7	5.3	n.p.	3.7	290	
Diseases of the genitourinary system 
(N00–N99)	2.6	3.0	4.0	4.0	2.5	n.p.	5.3	—	3.0	236	
Endocrine, nutritional and metabolic diseases (E00–E89)	2.2	2.7	2.6	1.3	2.5	n.p.	6.3	n.p.	2.4	187	
Diseases of the skin and subcutaneous tissue (L00–L99)	1.7	1.7	1.7	1.9	2.9	9.2	n.p.	—	1.9	149	
All other diagnoses	2.5	2.7	1.4	1.6	2.1	n.p.	n.p.	—	2.2	170	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
	Diagnosis rank		
Factors influencing health status and contact with health services (excluding Z75.1)	1	1	3	1	1	2	5	n.p.	1	1,543	
Diseases of the circulatory system (I00–I99)	3	2	1	2	2	1	2	n.p.	2	950	
Injury, poisoning and other consequences of external causes (S00–T98)	2	3	1	4	3	5	4	n.p.	3	871	
Mental and behavioural disorders (F00–F99)	5	6	5	3	4	2	5	n.p.	4	585	
Diseases of the respiratory system 
(J00–J99)	4	4	7	6	5	n.p.	1	n.p.	5	583	
Awaiting admission elsewhere (Z75.1)	6	7	4	9	8	n.p.	—	n.p.	6	500	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	8	5	6	4	7	n.p.	n.p.	n.p.	7	498	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	7	8	8	8	10	n.p.	3	n.p.	8	438	
Neoplasms (tumours and cancers) 
(C00–D48)	9	9	10	7	6	n.p.	8	—	9	397	
Diseases of the nervous system (G00–G99)	10	10	9	10	9	n.p.	n.p.	—	10	345	
Diseases of the digestive system (K00–K93)	11	11	12	12	11	5	8	n.p.	11	290	
Diseases of the genitourinary system 
(N00–N99)	12	12	11	11	13	n.p.	8	—	12	236	
Endocrine, nutritional and metabolic diseases (E00–E89)	13	13	13	14	13	n.p.	5	n.p.	13	187	
Diseases of the skin and subcutaneous tissue (L00–L99)	14	14	14	13	12	4	n.p.	—	14	149	
Total separations (number)	3,265	1,203	1,410	693	993	65	95	18		7,742	
							(continued)	
Table A.38 (cont’d):	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)
Movement type/principal diagnosis 
ICD-10-AM Ed. 2 chapter(a)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
To community/other	Column per cent		
Diseases of the circulatory system 
(I00–I99)	19.4	19.6	21.1	18.1	18.5	21.3	22.0	16.9	19.6	161,245	
Neoplasms (tumours and cancers) 
(C00–D48)	9.8	10.7	11.0	11.1	10.0	11.0	13.0	5.6	10.4	85,637	
Diseases of the digestive system 
(K00–K93)	10.4	9.8	10.8	10.6	10.1	9.5	9.8	8.0	10.3	84,363	
Diseases of the respiratory system 
(J00–J99)	9.0	8.4	8.7	8.6	9.1	9.1	8.0	16.2	8.8	72,063	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	7.7	7.0	8.0	10.1	7.9	9.1	10.5	4.8	7.9	64,878	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	7.5	8.1	8.4	6.8	7.8	6.3	6.0	8.0	7.7	63,407	
Factors influencing health status and contact with health services (excluding Z75.1)	8.4	9.4	4.8	6.3	8.2	5.4	4.1	5.2	7.6	62,542	
Injury, poisoning and other consequences of external causes (S00–T98)	7.1	6.4	7.0	7.0	6.1	7.4	7.1	9.8	6.8	55,741	
Diseases of the genitourinary system (N00–N99	6.1	5.7	6.4	6.2	6.3	5.7	7.3	7.3	6.1	49,913	
Endocrine, nutritional and metabolic diseases (E00–E89)	2.4	2.8	2.3	2.5	2.9	2.5	3.3	5.0	2.6	21,064	
All other diagnoses	12.2	12.1	11.5	12.7	13.0	12.6	8.9	13.3	12.2	99,764	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
	Diagnosis rank		
Diseases of the circulatory system 
(I00–I99)	1	1	1	1	1	1	1	1	1	161,245	
Neoplasms (tumours and cancers) 
(C00–D48)	3	2	2	2	3	2	2	7	2	85,637	
Diseases of the digestive system 
(K00–K93)	2	3	3	3	2	3	4	4	3	84,363	
Diseases of the respiratory system 
(J00–J99)	4	5	4	5	4	4	5	2	4	72,063	
Diseases of the musculoskeletal system and connective tissue (M00–M99)	6	7	6	4	6	5	3	10	5	64,878	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	7	6	5	7	7	7	8	4	6	63,407	
Factors influencing health status and contact with health services (excluding Z75.1)	5	4	9	8	5	9	9	8	7	62,542	
Injury, poisoning and other consequences of external causes (S00–T98)	8	8	7	6	9	6	7	3	8	55,741	
Diseases of the genitourinary system (N00–N99)	9	9	8	9	8	8	6	6	9	49,913	
Endocrine, nutritional and metabolic diseases (E00–E89)	12	10	11	11	10	11	10	9	11	21,064	
Total separations (number)	264,461	213,076	155,796	72,470	80,620	22,386	9,880	1,928	. .	820,617	
							(continued)	
Table A.38 (cont’d):	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)
Movement type/principal diagnosis ICD-10-AM Ed. 2 chapter(a)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
Died in hospital	Column per cent		
Neoplasms (tumours and cancers) (C00–D48)	28.3	28.2	28.9	28.0	30.2	28.2	33.2	18.1	28.6	14,672	
Diseases of the circulatory system 
(I00–I99)	25.6	24.7	25.7	24.4	26.4	28.9	25.2	27.6	25.4	13,060	
Diseases of the respiratory system (J00–J99)	15.5	13.7	13.9	13.9	13.3	12.1	13.5	12.4	14.3	7,346	
Diseases of the digestive system 
(K00–K93)	6.1	6.6	6.1	6.5	5.5	5.4	6.8	5.7	6.2	3,182	
Injury, poisoning and other consequences of external causes 
(S00–T98)	4.7	5.3	5.7	5.8	4.5	3.9	6.8	8.6	5.1	2,630	
Infectious and parasitic diseases 
(A00–B99)	3.9	2.9	3.1	2.9	2.8	2.7	1.5	9.5	3.3	1,679	
All other diagnoses	15.9	18.6	16.5	18.6	17.4	18.8	13.0	18.1	17.1	8,796	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
	Diagnosis rank		
Neoplasms (tumours and cancers) (C00–D48)	1	1	1	1	1	2	1	2	1	14,672	
Diseases of the circulatory system 
(I00–I99)	2	2	2	2	2	1	2	1	2	13,060	
Diseases of the respiratory system (J00–J99)	3	3	3	3	3	3	3	3	3	7,346	
Diseases of the digestive system 
(K00–K93)	4	4	4	4	4	4	4	6	4	3,182	
Injury, poisoning and other consequences of external causes 
(S00–T98)	5	5	5	5	5	7	4	5	5	2,630	
Infectious and parasitic diseases 
(A00–B99)	6	8	7	8	8	8	9	4	7	1,679	
Total separations (number)	17,874	13,740	9,048	4,297	4,636	1,074	591	105	. .	51,365	
								(continued)
	
Table A.38 (cont’d):	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)
Movement type/principal diagnosis ICD-10-AM Ed. 2 chapter(a)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
All movements from hospital	Column per cent		
Diseases of the circulatory system (I00–I99)	19.3	19.5	20.8	18.1	18.6	21.2	21.8	17.1	19.5	185,315	
Neoplasms (tumours and cancers) (C00–D48)	10.4	11.2	11.5	11.4	10.7	11.5	13.5	6.0	11.0	104,410	
Diseases of the digestive system (K00–K93)	9.9	9.3	10.3	10.2	9.6	9.2	9.5	8.4	9.8	92,849	
Diseases of the respiratory system (J00–J99)	9.6	8.8	9.0	9.0	9.5	9.2	8.7	15.9	9.2	87,452	
Factors influencing health status and contact with health services (excluding Z75.1)	8.5	9.1	4.8	6.8	8.0	5.3	3.9	5.1	7.6	72,178	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	7.0	7.8	7.9	6.6	7.4	6.0	5.7	7.6	7.4	69,762	
Diseases of the musculoskeletal system and connective tissue 
(M00–M99)	6.9	6.4	7.3	9.2	7.2	8.4	9.7	4.6	7.2	67,987	
Injury, poisoning and other consequences of external causes (S00–T98)	7.4	6.7	7.3	7.2	6.5	7.6	7.7	9.8	7.1	67,170	
Diseases of the genitourinary system (N00–N99)	5.8	5.5	6.1	6.0	6.1	5.6	7.1	6.9	5.8	55,423	
All other diagnoses	15.1	15.6	14.8	15.6	16.4	16.2	12.4	18.5	15.4	145,615	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
	Diagnosis rank		
Diseases of the circulatory system (I00–I99)	1	1	1	1	1	1	1	1	1	185,315	
Neoplasms (tumours and cancers) (C00–D48)	2	2	2	2	2	2	2	7	2	104,410	
Diseases of the digestive system (K00–K93)	3	3	3	3	3	4	4	4	3	92,849	
Diseases of the respiratory system (J00–J99)	4	5	4	5	4	3	5	2	4	87,452	
Factors influencing health status and contact with health services (excluding Z75.1)	5	4	9	7	5	9	9	8	5	72,178	
Symptoms, signs and abnormal findings n.e.c. (R00–R99)	7	6	5	8	6	7	8	5	6	69,762	
Diseases of the musculoskeletal system and connective tissue 
(M00–M99)	8	8	6	4	7	5	3	10	7	67,987	
Injury, poisoning and other consequences of external causes (S00–T98)	6	7	7	6	8	6	6	3	8	67,170	
Diseases of the genitourinary system (N00–N99)	9	9	8	9	9	8	7	6	9	55,423	
Total separations (number)	308,715	244,101	179,797	83,689	93,577	24,913	11,216	2,153	. .	948,161	
(a)	Diagnosis relates to that recorded during the last hospital episode before discharge from the hospital system (see Box 1.1). See Appendix C for conditions included in ICD-10-AM chapters. Hospital separations with a principal diagnosis of ‘Awaiting admission elsewhere (Z75.1)’ have been removed from the ICD-10-AM chapter ‘Factors influencing health status and contact with health services’ and shown separately.
Notes
1.	Table is based on linked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of hospital admission.
3.	Within a movement type a diagnosis was selected if it contributed to at least 5 per cent of hospital separations for any of the jurisdictions. 
Table A.39:	RAC entries for people aged 65+: per cent high care by movement type by care level on transition by state/territory, 2001–02 (unadjusted)
 	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	All	N	
Movement type	Per cent at high care		
Return from hospital 	59.5	44.6	60.5	61.7	45.0	66.6	54.4	86.5	55.4	47,004	
Return from social leave	36.8	29.7	30.9	39.9	23.4	52.6	45.2	69.0	33.7	48,304	
Into permanent RAC from hospital	88.1	76.5	81.4	86.0	74.7	87.5	88.7	85.0	82.6	20,125	
Into respite RAC from hospital	49.6	26.7	47.5	51.7	17.9	31.8	37.4	61.1	42.8	7,744	
Transfer into permanent RAC 	74.7	70.2	73.5	78.0	53.6	81.0	70.2	77.8	72.2	19,508	
Transfer into respite RAC 	57.5	46.2	50.8	52.7	29.0	36.1	60.0	n.p.	50.9	1,375	
Into permanent RAC from community	47.0	34.3	35.0	38.5	41.7	49.5	32.6	72.7	40.1	18,261	
Into respite RAC from community	40.3	29.1	35.8	26.7	19.3	35.8	30.5	64.4	33.8	32,893	
All	53.7	43.3	48.6	53.8	37.4	54.9	47.1	71.2	48.9	. .	
Total admissions (number)	69,336	44,334	37,892	18,598	17,172	5,042	2,340	500	. .	195,214	
Notes
1.	Table is based on linked and unlinked and unlinked hospital and RAC records. See notes to Table 1.3 for information on identification of transition groups; see Box 2.1 concerning interpretation of unadjusted numbers.
2.	Age is as at time of RAC event. 
3.	‘Return from social leave’ excludes those linked to a hospital separation. Linked social leave events are included in ‘Return from hospital’.

Appendix B: Data linkage 
B.1	Transition events
In linking hospital and RAC data to investigate movement from hospital into RAC, the aim of the linkage strategy is to match hospital separations by people who then go directly (or almost directly) into RAC. 
In general, an episode in hospital may end with the patient either: 
a	returning home in the community or going to live temporarily with family and friends
b	going to live temporarily with family and friends before returning to a RAC service
c	going into a RAC service
d	returning to their home in permanent RAC 
e	transferring to another hospital
f	transferring to residential health care services
g	changing episode type within the hospital
h	dying.
Similarly, a person may enter RAC in a number of ways. An entry may be for a person:
A	being admitted into RAC for permanent care
B	being admitted into RAC for respite care
C	transferring between RAC services (for either permanent or respite care)
D	returning to permanent RAC following an episode in hospital (termed ‘hospital leave’)
E	returning to permanent RAC following a stay with family or friends (termed ‘social leave’)
F	In addition, a RAC permanent resident may die while on hospital leave or die in hospital while on social leave.
In terms of the events described above, the linkage strategy aims to match hospital separations of type c to the relevant RAC entries of types A and B; separations of type d to entries of type D (or occasionally E); separations of type b to the relevant entries of type E, and separations of type h to deaths of aged care residents while in hospital (type F). 
B.2	Data
The hospital data used in this study came from the NHMD, and included data for both public and private hospital separations. Two sets of records were excluded:
•	Statistical discharges and transfers: for two types of separations the person remains within the hospital system. In a ‘statistical discharge’ the person in question changes from one hospital episode care type to another (for example, from acute care to rehabilitation). A person may also transfer from one hospital to another. As these people do not leave the hospital system, trying to link to a RAC entry is not appropriate. Consequently, separation records relating to statistical discharges and transfers were excluded.
•	Same day hospital separations: people admitted and discharged on the same day are unlikely to be discharged to a RAC facility unless they have come from a RAC facility to hospital for a day procedure. In this case the person is unlikely to be recorded as being on hospital leave by the RAC facility (analysis of recorded RAC hospital leave revealed only events with at least one night in hospital). Therefore to avoid spurious matches between aged care admissions and hospital separations into the community, records with the same admission and separation dates were excluded. The effect of excluding same-day hospital separations on the links made is negligible: during 2004–05, just 0.4% of same-day hospital separations for people aged 65 and over were reported as discharges to RAC or other health care (AIHW: Karmel et al. 2007b).
The RAC data were derived from the Department of Health and Ageing’s ACCMIS database. As seen in Section B.1, there are three ways a client may enter or re-enter RAC:
•	As a new admission, for either permanent or respite care. A permanent admission may be preceded by pre-entry leave of up to 7 days.
•	Returning from hospital leave after a permanent resident has had a period in hospital. 
•	Returning from social leave after a permanent resident has had a period away from the RAC facility visiting family and/or friends.
The RAC data used in the analysis included all RAC permanent and respite admissions and hospital and social leave events for the year of interest. Pre-entry leave associated with a permanent admission was identified but not included as a separate event.
B.3	Linkage protocol
To protect the privacy of individuals, the linkage was carried out by the Institute using the Institute’s protocol Data linkage and protecting privacy: a protocol for linking between two or more data sets held within the Australian Institute of Health and Welfare (AIHW 2006). The principles underlying this protocol are that:
 •   Data linkage is not carried out directly between original complete data sets
 •	Data linkage is undertaken using purpose-specific linkage data sets that contain only the data required for establishing and validating links 
 •	Links between data sets are recorded using project specific unique record identifiers so that links identified for a particular project (including longitudinal analyses) cannot be used to establish links between data sets outside the scope of the project using a chain of links (‘consequential’ linking)
 •	Analysis files do not contain identifying data (such as name, date of birth and address, or the record number from the original data set) 
 •	Intermediate data sets and the project specific record identifiers are deleted following completion of the final linked analysis data sets. (AIHW 2006).
B.4	Linkage process: constrained event-based matching 
While neither name nor a common person identification number are available for linking data from the hospital NHMD and RAC data sets, sufficient demographic and event data are available to connect hospital–RAC transition events using event-based matching (see Karmel & Gibson 2007 and AIHW: Karmel & Rosman 2007 for development of the method). In this linkage process matching is based on date of birth, sex, region of usual residence, and hospital separation and RAC entry event dates and characteristics. 
In a comparative analysis a number of event-based linkage strategies were compared with the Western Australian Department of Health’s name-based approach. Results from that work identified a constrained version of the linkage strategy as the most appropriate for national analyses (AIHW: Karmel & Rosman 2007 and further unpublished analysis). The purpose of constrained event-based matching is to find the best match using all relevant event date information and event descriptors on the national NHMD and ACCMIS data. To achieve this, matching procedures are specified separately for comparisons between different subsets of RAC and hospital events, defined in terms of their type and/or admission and separation characteristics. Because two dates are available for RAC hospital leave, and the related hospital episode may end in a number of ways, match procedures for these events are the most complicated. The specific information used in the matching process is:
•	date of birth
•	sex
•	postcode of usual residence
•	postcode of hospital
•	postcode of RAC facility
•	hospital episode start and end dates
•	RAC event start and end dates (including pre-entry leave dates for associated permanent admissions)
•	whether an aged care assessment occurred in hospital
•	aged care assessment date (if in hospital)
•	reported hospital mode of admission and separation
•	RAC event type.
Event information may suggest that some matches are more likely to be correct than others (for example, a link of hospital discharge reported as to RAC – RAC admission has greater face validity than a link of hospital discharge reported as to usual residence – RAC admission). Thus, data set partitioning based on event characteristics not only minimises coincident records within data sets (with respect to variables used when matching) by reducing the number of records being compared at a time, but also allows link priorities to be set later in the matching process. Consequently, matching within partitioned data sets facilitates selection of the most likely match if duplicate links occur when the links from the partitioned data sets are combined. For this project 12 such partitioned data set pairs were used (Table B.1). 
Table B.1:	Data set partitioning and event date match rules for event-based constrained match selection
Partition code	Link priority	Reported hospital mode of separation	RAC type	RAC exit : hospital entry dates	Hospital exit : RAC entry dates	
						
8ADM	11	To death, using person region(a)	Admissions	.  .	|RAC entry – Hospital exit | ≤ 2 days
or
|RAC pre-entry – Hospital exit | ≤ 2 days	
9ADM	8	To usual residence (for matching using person region)	Admissions			
0ADM	7	To other (for matching using person region)	Admissions			
						
H9ADM	10	To usual residence (for matching using hospital region)	Admissions with ACAT in hospital	(also Hospital entry ≤ ACAT date ≤ Hospital exit)		
H0ADM	9	To other (for matching using hospital region)	Admissions with ACAT in hospital			
						
9SOC	12	All	Social leave	RAC exit ≤ Hospital entry	Hospital exit ≤ RAC entry	
						
NST8H	2	With non-statistical admission, to death	Hospital leave	|Hospital entry – RAC exit | = 0, 1, 2 days	(RAC entry – Hospital exit) ≤ 2 days(b)	
NST9H	1	With non-statistical admission, to usual residence	Hospital leave			
NST0H	3	With non-statistical admission, to other	Hospital leave			
						
ST8H	5	With statistical admission, to death	Hospital leave	(Hospital entry – RAC exit) ≥ –2	(RAC entry – Hospital exit) ≤ 2 days(b)	
ST9H	4	With statistical admission, to usual residence	Hospital leave		(RAC entry – Hospital exit) = 0, 1, 2 days(c)	
ST0H	6	With statistical admission, to other	Hospital leave			
(a)	For this analysis, regions were defined by postcode.
(b)	Allows for discharge to hospital (negative difference).
(c)	Stricter rules on end-date because it is difficult to allow consistently for death in hospital for a statistical admission, and to compensate for the poorer match event start date.
Source: AIHW: Karmel & Rosman 2007.
Constrained event-based matching was carried out in two stages. Initial matches for each partitioned data set pair were selected using 1:1 probabilistic matching via the matching software Websphere® (previously known as Automatch® and Integrity®). In this stage, relatively broad match criteria were used to identify possible matches between RAC and hospital partitioned data sets. While the matching was probabilistic, at least partial matches were required on each of date of birth, sex, region and event dates. Some variation was allowed in exactness of match, particularly for event dates where allowable date differences between the RAC and hospital events were specified according to the types of events being matched (see Table B1). In terms of event dates, delays of up to 2 days between hospital exit and RAC entry were allowed when identifying transition events (with the exception of cases with arranged RAC pre-entry leave where gaps of up to 9 days were allowed). Some variation in date of birth (matching on two out of day, month and year of birth) and region was also allowed. 
The extent of variation allowed in the Websphere® matching process is shown in Table B.2 which summarises the general approach taken to blocking (required match) and match variable (probabilistic match) specifications, with the particular specifications depending on the two data sets being compared (as per Table B.1).
Table B.2:	Blocking variables and matching description used in Websphere® passes for constrained event-based linkage strategy
	Websphere® pass 	
	1	2	3	4	5	6	7	
Matching between hospital separations and RAC admissions	
Match description	Exact match 	Exact match	1-sided event date variation	2-sided event date variation	Year of birth variation	Month and/or day of birth variation	Exact match using RAC outlet 3 digit postcode 	
								
Blocking variables	–postcode(a)
–sex
–DOB
–event date(b)	–3 digit postcode
–sex
–DOB
–event date	–3 digit postcode
–sex
–DOB
	–3 digit postcode
–sex
–DOB
	–3 digit postcode
–sex
–day of birth
–month of birth
–event date	–3 digit postcode
–sex
–year of birth
–event date	–3 digit postcode
–sex
–DOB
–event date	
Matching between hospital separations and RAC leave events	
Match description	Exact match 	Exact match	1-sided event date(s) variation	2-sided event date(s) variation	Year of birth variation	Variation in month of birth 	Variation in day of birth 	
								
Blocking variables	–postcode(c)
–sex
–DOB
–event date(s)	–3 digit postcode
–sex
–DOB event date(s)	–3 digit postcode
–sex
–DOB
	–3 digit postcode
–sex
–DOB	–3 digit postcode
–sex
–day of birth
–month of birth
–event date(s)	–3 digit postcode
–sex
–day of birth 
–year of birth
–event date(s)	–3 digit postcode
–sex
–month of birth
–year of birth
–event date(s)	
(a)	Matching used NHMD postcode as specified in Table B.1. RAC postcode relates to client’s usual residence prior to RAC admission except in pass 7.
(b)	Dates were only used as blocking variables if an exact date match was appropriate for the particular partitioned data set pair being matched. This depended on whether RAC leave events or admissions were being compared, and whether a death/discharge to hospital was involved (see Table B.1, see also diagrams in AIHW: Karmel & Rosman 2007:Appendix 2 for more detail). When exact date matches were not appropriate, event dates were used as match variables.
(c)	Matching used client postcode on NHMD and RAC facility postcode as the RAC facility is the usual residence for a person on RAC leave.
Notes
1.	Pass 6 (month or day of birth variation) was not used when matching partition pair codes 9ADM and H9ADM in Table B.1. In addition, passes 3 and 4 (date variation) and pass 5 (year of birth variation) were not used for partition pair H9ADM.
2.	Only pass 1 was used when matching to RAC social leave, where an exact match for RAC social leave means that the hospital episode dates were contained within the leave event dates (see partition code 9SOC Table B.1).
3.	‘3 digit postcode’ indicates that the first three digits of the postcode were used for region matching.
In the second stage of match selection, the results from matching within the 12 partitioned data set pairs were checked for compliance with the rules for acceptable variation (Table B.1). In addition, any links for permanent residents who did not return to RAC following a period of hospitalisation, due to either RAC discharge into hospital or death in hospital, were identified and excluded as they did not involve movement from hospital into RAC. The 
12 data sets were then combined. 
Combining the 12 linked sets resulting from the above process resulted in a number of 
many-to-many matches; this was because there was overlap across the partitioned data set pairs; for example, all RAC admissions were compared with the three data sets containing hospital separations to death, separations to usual residence/other and other separations. These duplicate links were reduced to a 1:1 match using priority ratings which ranked matches based on RAC event type, reliability of region information and hospital separation mode (see Table B.1). Overall, links to RAC hospital leave were given top priority, followed by those to RAC admissions and finally those to RAC social leave. RAC social leave was given low priority because of the less reliable event date data available for these matches, and because people who go on social leave are likely to be the more robust RAC residents and so less likely to use hospital (the better health of people who use social leave is confirmed in 
Table A.39). More details concerning match specifications and priorities for constrained 
event-based linkage are given in AIHW: Karmel & Rosman 2007.
The processes outlined above were tailored to identify uni-directional moves from hospital to RAC. Both data set preparation and match strategies would need to be adjusted to be able to identify all moves in both directions.
B.4.1	Data quality for matching
The quality of the final linked data set depends largely on the quality of the data in the input data sets. The quality of the NHMD and RAC data sets has been assessed previously in some detail with respect to the following:
•	duplicates in the data sets based on match variables
•	missing data relating to match variables 
•	over-occurrence of certain birth dates (AIHW: Karmel et al. 2007a:section 5.1).
The presence of high numbers of duplicates within a data set for a given date of birth, sex, postcode and transition date combination would lead to an increased chance of an incorrect link being made. However, exact duplicates based on these match variables were rare, with duplicate rates of under 0.02% for both data sets. Consequently duplicates have a negligible effect on the quality of the final linked data set.
In general, missing data for match variables was uncommon, and across all match variables RAC data had very low levels of missing data. The data most affected by missing values was postcode on the NHMD, with client postcode missing for 0.4% of hospital separations. A seemingly major quality issue with the NHMD data set was that more than one-third of all records were missing the hospital postcode (based on data for six jurisdictions). These records represent separations from private hospitals, for which postcodes are not recorded on the NHMD. However, because hospital postcodes were used to identify just over 1% of the total links in the comparative linkage study (AIHW: Karmel & Rosman 2007), it is estimated that the large numbers of missing hospital postcodes in the present study would have resulted in only a relatively small number of missed links (that is, approximately 1% of the final number of links).
Previous analysis has shown that 1 January and 1 July dates of birth are over-represented in both the hospital and RAC data sets (AIHW: Karmel et al. 2007a:section 5.1). This suggests that these dates are commonly used as proxy missing value codes when a person’s date of birth is unknown. It is expected that linked records with these birth dates have a high probability of being correct links, given that linkage was performed using other criteria such as location and event dates, and duplicate records were rare. Based on the Western Australian experience a very small number of links are likely to have been missed as a result of the 
over-occurrence of 1 January and 1 July birth dates. However, the over-reporting of 1 January and 1 July birth dates is more pronounced for Indigenous than non-Indigenous clients. The consequence of this is that there will be a greater percentage of missed links among Indigenous Australians than other Australians, with the Northern Territory being particularly affected because of its large Indigenous population.
B.5	Link accuracy 
When linking records four outcomes are possible: a true link, no link, a mis-link (false positive) and a missed link (false negative). The correspondence between two strategies can be gauged by seeing how many of the links are the same and how many are different. In the comparative study using Western Australian data, transition links from event-based linkage were compared directly with those from a name-based approach. Although subject to some constraints imposed by the data providers, the Health Information Linkage Branch in the Western Australian Department of Health was able to use name and address to link transition events in Western Australian RAC and hospital data, supported by the availability of name and address reporting history across a range of health service events. This resulted in this linkage being highly reliable and, consequently, it served as the reference standard against which the event-based linkage results were compared; that is, to determine whether an 
event-based link was ‘true’ or ‘false’. Note, however, that no linkage system is error proof, and a number of cases were identified where manual inspection indicated that an event-based linkage match was the preferred link. In addition, event-based linkage identified a small number of valid person links that had previously been missed using name and address information.
Two key measures were used when comparing matches:
•	Positive predictive value (PPV): the percentage of event-based links that were true links
= event-based true links/event-based links
•	Sensitivity: the percentage of all links that were identified by the event-based linkage strategy
= event-based true links/name-based links.
As seen from the linkage comparison using Western Australian data (Table B.3), event-based linkage more often tends to miss matches than make false matches (sensitivity < PPV). As a consequence, the volume of flow from hospital to RAC is underestimated when using 
event-based linkage. However, given that the event-based linkage strategy results in few false matches (PPVs between 95% and 99% depending on the event type) and linkage sensitivities are reasonably consistent (88%–92%), the linked data set provides a strong basis for examining transitions between hospital and RAC. The comparative study also confirmed the utility of the linked data for analyses of transition events (AIHW: Karmel & Rosman 2007:chapter 8).
Table B.3:	PPV and sensitivity of preferred event-based linkage strategy, using Western Australian name-based linkage as the reference standard, linkage comparative study for 2000–01
	Links to RAC event type:	Total	
	Permanent admission	Respite admission	Hospital leave	Social
 leave		
PPV (per cent)	95.3	97.9	98.7	99.3	97.9	
Sensitivity (per cent)	88.0	88.0	91.7	90.7	90.5	
Relative size (per cent)	92.3	89.9	92.9	91.3	92.4	
Note: Relative size is the ratio of the number of links identified by event-based linkage with the number identified using the name-based system, irrespective of correctness of link.
B.6	Estimates of total flow 
Although the consistent sensitivities and relative size seen in Table B.3 indicate that the linked data can be used to measure relativities between different types of transitions from hospital into RAC, as stated above event-based linkage underestimates the total number of transitions and so cannot be used without adjustment to measure the volume of flow from hospital to RAC. While the Western Australian project was a one-off study limited to one year and one state, it is felt important to produce some estimates for the overall flow of older people from hospital to RAC. To this end, approximate estimates were derived using adjustments based on the results from the Western Australian study.
The approach taken when developing the adjustments was to find a broad 
cross-classification within which simple multiplicative factors, derived from the Western Australian study, could be applied to the event-based links. After investigation, a system based on adjustment at the RAC event type by hospital care type level was derived and used for preliminary results using data from six jurisdictions (for details see AIHW: Karmel et al. 2007a:section 5.3). However, further investigation of national data indicated that in 2001–02 jurisdictions classified some care types differently (affecting particularly the categories GEM and maintenance care). Therefore, to avoid possible biases caused by varying reporting practices and given that analysis of propensity to miss links did not suggest any other suitable adjustment variables (AIHW: Karmel & Rosman 2007:50–3), adjustments for this report were based solely on transition type. The final factors applied to hospital–RAC links relating to specified RAC entry event types are presented in Table B.4. Adjusted estimates of numbers in the various transition groups were then derived as follows:
Step 1: Using the adjustment factors, derive adjusted estimates of separations from hospital to RAC for those:
•	returning to permanent RAC 
•	admitted to permanent RAC
•	admitted to respite RAC.
Step 2: For transitions from hospital: 
•	identify deaths in hospital—these figures remain unadjusted
•	estimate transitions from hospital to the community by subtracting deaths in hospital and adjusted estimates of separations to RAC from the total number of separations.
Step 3: For admissions into RAC: 
•	identify permanent and respite admissions which relate to transfers between RAC services—these figures remain unadjusted
•	estimate admissions into RAC from the community by subtracting within-RAC transfers and adjusted estimates of admissions to RAC from hospital (from Step 1) from the total number of admissions (for permanent and respite care separately).
It needs to be remembered that the factors in Table B.4 were derived using Western Australian data for the 2000–01 financial year and are now being applied to other jurisdictions for the 2001–02 financial year. As a result, they provide estimates only for adjustments factors for the present study, and are used in this report solely to provide approximate estimates of the volume of flow at the national level. Future projects may adopt different methodologies.

Table B.4:	Final adjustments for estimates of flow by RAC event type and hospital care type of link, from Western Australian linkage study for 2000–01
RAC event type	Number of
 name-based links	Number of 
event-based links	Adjustment factor	
Admitted to permanent RAC	1,723	1,590	1.08	
Admitted to respite RAC	852	766	1.11	
Return from RAC leave	5,531	5,135	1.08	

Appendix C: ICD-10-AM Edition 2 chapters
Chapter I: Certain infectious and parasitic diseases (A00–B99)
A00–A09	Intestinal infectious diseases
A15–A19	Tuberculosis
A20–A28	Certain zoonotic bacterial diseases
A30–A49	Other bacterial diseases
A50–A64	Infections with a predominantly sexual mode of transmission
A65–A69	Other spirochaetal diseases
A70–A74	Other diseases caused by chlamydiae
A75–A79	Rickettsioses
A80–A89	Viral infections of the central nervous system
A90–A99	Arthropod-borne viral fevers and viral haemorrhagic fevers
B00–B09	Viral infections characterised by skin and mucous membrane lesions
B15–B19	Viral hepatitis
B20–B24	Human immunodeficiency virus [HIV] disease
B25–B34	Other viral diseases
B35–B49	Mycoses
B50–B64	Protozoal diseases
B65–B83	Helminthiases
B85–B89	Pediculosis, acariasis and other infestations
B90–B94	Sequelae of infectious and parasitic diseases
B95–B97	Bacterial, viral and other infectious agents
B99	Other infectious diseases
Includes:	Diseases generally recognised as communicable or transmissible
Excludes:	Carrier or suspected carrier of infectious disease (Z22.-)
Certain localised infections — see body system-related chapters infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium [except obstetrical tetanus and human immunodeficiency virus [HIV] disease] (O98.-)
Infectious and parasitic diseases specific to the perinatal period [except tetanus neonatorum, congenital syphilis, perinatal gonococcal infection and perinatal human immunodeficiency virus [HIV] disease] (P35–P39)
Influenza and other acute respiratory infections (J00–J22)
Chapter II: Neoplasms (C00–D48)
C00–C96	Malignant neoplasms
D00–D09	In situ neoplasms
D10–D36	Benign neoplasms
D37–D48	Neoplasms of uncertain or unknown behaviour
Chapter III: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50–D89)
D50–D53	Nutritional anaemias
D55–D59	Haemolytic anaemias
D60–D64	Aplastic and other anaemias
D65–D69	Coagulation defects, purpura and other haemorrhagic conditions
D70–D77	Other diseases of blood and blood-forming organs
D80–D89	Certain disorders involving the immune mechanism
Excludes:	Exclusion groups a, c, d, e, f, g and h (see below)
	Autoimmune disease (systemic) NOS (M35.9)
	Human immunodeficiency virus [HIV] disease (B20–B24)
Chapter IV: Endocrine, nutritional and metabolic diseases (E00–E90)
E00–E07	Disorders of thyroid gland
E10–E14	Diabetes mellitus
E15–E16	Other disorders of glucose regulation and pancreatic internal secretion
E20–E35	Disorders of other endocrine glands
E40–E46	Malnutrition
E50–E64	Other nutritional deficiencies
E65–E68	Obesity and other hyperalimentation
E70–E90	Metabolic disorders
Excludes:	Exclusion groups c and h (see below)
	Transitory endocrine and metabolic disorders specific to fetus and newborn (P70–P74)
Chapter V: Mental and behavioural disorders (F00–F99)
F00–F09	Organic, including symptomatic, mental disorders
F10–F19	Mental and behavioural disorders due to psychoactive substance use
F20–F29	Schizophrenia, schizotypal and delusional disorders
F30–F39	Mood [affective] disorders
F40–F48	Neurotic, stress-related and somatoform disorders
F50–F59	Behavioural syndromes associated with physiological disturbances and physical factors
F60–F69	Disorders of adult personality and behaviour
F70–F79	Mental retardation
F80–F89	Disorders of psychological development
F90–F98	Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
F99	Unspecified mental disorder
Includes:	Disorders of psychological development
Excludes:	Exclusion group h (see below)
Chapter VI: Diseases of the nervous system (G00–G99)
G00–G09	Inflammatory diseases of the central nervous system
G10–G13	Systemic atrophies primarily affecting the central nervous system
G20–G26	Extrapyramidal and movement disorders
G30–G32	Other degenerative diseases of the nervous system
G35–G37	Demyelinating diseases of the central nervous system
G40–G47	Episodic and paroxysmal disorders
G50–G59	Nerve, nerve root and plexus disorders
G60–G64	Polyneuropathies and other disorders of the peripheral nervous system
G70–G73	Diseases of myoneural junction and muscle
G80–G83	Cerebral palsy and other paralytic syndromes
G90–G99	Other disorders of the nervous system
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
Chapter VII: Diseases of the eye and adnexa (H00–H59)
H00–H06	Disorders of eyelid, lacrimal system and orbit
H10–H13	Disorders of conjunctiva
H15–H22	Disorders of sclera, cornea, iris and ciliary body
H25–H28	Disorders of lens
H30–H36	Disorders of choroid and retina
H40–H42	Glaucoma
H43–H45	Disorders of vitreous body and globe
H46–H48	Disorders of optic nerve and visual pathways
H49–H52	Disorders of ocular muscles, binocular movement, accommodation and refraction
H53–H54	Visual disturbances and blindness
H55–H59	Other disorders of eye and adnexa
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
Chapter VIII: Diseases of the ear and mastoid process (H60–H95)
H60–H62	Diseases of external ear
H65–H75	Diseases of middle ear and mastoid
H80–H83	Diseases of inner ear
H90–H95	Other disorders of ear
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
Chapter IX: Diseases of the circulatory system (I00–I99)
I00–I02	Acute rheumatic fever
I05–I09	Chronic rheumatic heart diseases
I10–I15	Hypertensive diseases
I20–I25	Ischaemic heart diseases
I26–I28	Pulmonary heart disease and diseases of pulmonary circulation
I30–I52	Other forms of heart disease
I60–I69	Cerebrovascular diseases
I70–I79	Diseases of arteries, arterioles and capillaries
I80–I89	Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified
I95–I99	Other and unspecified disorders of the circulatory system
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
	Systemic connective tissue disorders (M30–M36)
	Transient cerebral ischaemic attacks and related syndromes (G45.-)

Chapter X: Diseases of the respiratory system (J00–J99)
J00–J06	Acute upper respiratory infections
J10–J18	Influenza and pneumonia
J20–J22	Other acute lower respiratory infections
J30–J39	Other diseases of upper respiratory tract
J40–J47	Chronic lower respiratory diseases
J60–J70	Lung diseases due to external agents
J80–J84	Other respiratory diseases principally affecting the interstitium
J85–J86	Suppurative and necrotic conditions of lower respiratory tract
J90–J94	Other diseases of pleura
J95–J99	Other diseases of the respiratory system
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
Chapter XI: Diseases of the digestive system (K00–K93)
K00–K14	Diseases of oral cavity, salivary glands and jaws
K20–K31	Diseases of oesophagus, stomach and duodenum
K35–K38	Diseases of appendix
K40–K46	Hernia
K50–K52	Noninfective enteritis and colitis
K55–K63	Other diseases of intestines
K65–K67	Diseases of peritoneum
K70–K77	Diseases of liver
K80–K87	Disorders of gallbladder, biliary tract and pancreas
K90–K93	Other diseases of the digestive system
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
Chapter XII: Diseases of the skin and subcutaneous tissue (L00–L99)
L00–L08	Infections of the skin and subcutaneous tissue
L10–L14	Bullous disorders
L20–L30	Dermatitis and eczema
L40–L45	Papulosquamous disorders
L50–L54	Urticaria and erythema
L55–L59	Radiation-related disorders of the skin and subcutaneous tissue
L60–L75	Disorders of skin appendages
L80–L99	Other disorders of the skin and subcutaneous tissue
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
	Lipomelanotic reticulosis (I89.8)
	Systemic connective tissue disorders (M30–M36)
Chapter XIII: Diseases of the musculoskeletal system and connective tissue (M00–M99)
M00–M25	Arthropathies
M30–M36	Systemic connective tissue disorders
M40–M54	Dorsopathies
M60–M79	Soft tissue disorders
M80–M94	Osteopathies and chondropathies
M95–M99	Other disorders of the musculoskeletal system and connective tissue
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
	Compartment syndrome (T79.6)
Chapter XIV: Diseases of the genitourinary system (N00–N99)
N00–N08	Glomerular diseases
N10–N16	Renal tubulo-interstitial diseases
N17–N19	Renal failure
N20–N23	Urolithiasis
N25–N29	Other disorders of kidney and ureter
N30–N39	Other diseases of urinary system
N40–N51	Diseases of male genital organs
N60–N64	Disorders of breast
N70–N77	Inflammatory diseases of female pelvic organs
N80–N98	Noninflammatory disorders of female genital tract
N99	Other disorders of genitourinary tract
Excludes:	Exclusion groups a, b, c, d, e, f, g and h (see below)
Chapter XV: Pregnancy, childbirth and the puerperium (O00–O99)
Not applicable 
Chapter XVI: Certain conditions originating in the perinatal period (P00–P96)
Not applicable
Chapter XVII: Congenital malformations, deformations and chromosomal abnormalities (Q00–Q99)
Q00–Q07	Congenital malformations of the nervous system
Q10–Q18	Congenital malformations of eye, ear, face and neck
Q20–Q28	Congenital malformations of the circulatory system
Q30–Q34	Congenital malformations of the respiratory system
Q35–Q37	Cleft lip and cleft palate
Q38–Q45	Other congenital malformations of the digestive system
Q50–Q56	Congenital malformations of genital organs
Q60–Q64	Congenital malformations of the urinary system
Q65–Q79	Congenital malformations and deformations of the musculoskeletal system
Q80–Q89	Other congenital malformations
Q90–Q99	Chromosomal abnormalities, not elsewhere classified
Excludes:	Inborn errors of metabolism (E70–E90)
Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00–R99)
This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded. 
Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. 
R10–R19	Symptoms and signs involving the digestive system and abdomen
R20–R23	Symptoms and signs involving the skin and subcutaneous tissue
R25–R29	Symptoms and signs involving the nervous and musculoskeletal systems
R30–R39	Symptoms and signs involving the urinary system
R40–R46	Symptoms and signs involving cognition, perception, emotional state and behaviour
R47–R49	Symptoms and signs involving speech and voice
R50–R69	General symptoms and signs
R70–R79	Abnormal findings on examination of blood, without diagnosis
R80–R82	Abnormal findings on examination of urine, without diagnosis
R83–R89	Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis
R90–R94	Abnormal findings on diagnostic imaging and in function studies, without diagnosis
R95–R99	Ill-defined and unknown causes of mortality
Excludes:	Exclusion group a (see below)
	Abnormal findings on antenatal screening of mother (O28.-)
Chapter XIX: Injury, poisoning and certain other consequences of external causes 
(S00–T98)
S00–S09	Injuries to the head
S10–S19	Injuries to the neck
S20–S29	Injuries to the thorax
S30–S39	Injuries to the abdomen, lower back, lumbar spine and pelvis
S40–S49	Injuries to the shoulder and upper arm
S50–S59	Injuries to the elbow and forearm
S60–S69	Injuries to the wrist and hand
S70–S79	Injuries to the hip and thigh
S80–S89	Injuries to the knee and lower leg
S90–S99	Injuries to the ankle and foot
T00–T07	Injuries involving multiple body regions
T08–T14	Injuries to unspecified part of trunk, limb or body region
T15–T19	Effects of foreign body entering through natural orifice
T20–T31	Burns
T33–T35	Frostbite
T36–T50	Poisoning by drugs, medicaments and biological substances
T51–T65	Toxic effects of substances chiefly nonmedicinal as to source
T66–T78	Other and unspecified effects of external causes
T79	Certain early complications of trauma
T80–T88	Complications of surgical and medical care, not elsewhere classified
T89	Other complications of trauma not elsewhere classified
T90–T98	Sequelae of injuries, of poisoning and of other consequences of external causes
Excludes:	Birth trauma (P10–P15)
	Obstetric trauma (O70–O71)
Note:	The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to multiple or unspecified body regions as well as poisoning and certain other consequences of external causes. 
Chapter XX: External causes of morbidity and mortality (V01–Y98)
V01–X59	Accidents
•	V01–V99	Transport accidents
•	W00–X59	Other external causes of accidental injury
X60–X84	Intentional self-harm
X85–Y09	Assault
Y10–Y34	Event of undetermined intent
Y35–Y36	Legal intervention and operations of war
Y40–Y84	Complications of medical and surgical care
Y85–Y89	Sequelae of external causes of morbidity and mortality
Y90–Y98	Supplementary factors related to causes of morbidity and mortality classified elsewhere
Chapter XXI: Factors influencing health status and contact with health services (Z00–Z99)
Z00–Z13	Persons encountering health services for examination and investigation
Z20–Z29	Persons with potential health hazards related to communicable diseases
Z30–Z39	Persons encountering health services in circumstances related to reproduction
Z40–Z54	Persons encountering health services for specific procedures and health care
Z55–Z65	Persons with potential health hazards related to socioeconomic and psychosocial circumstances
Z70–Z76	Persons encountering health services in other circumstances
•	Z75	Problems related to medical facilities and other health care
o	Z75.1	Person awaiting admission to adequate facility elsewhere
Z80–Z99	Persons with potential health hazards related to family and personal history and certain conditions influencing health status
Exclusion groups:
a.	Certain conditions originating in the perinatal period (P00–P96)
b.	Certain infectious and parasitic diseases (A00–B99)
c.	Complications of pregnancy, childbirth and the puerperium (O00–O99)
d.	Congenital malformations, deformations and chromosomal abnormalities (Q00–Q99)
e.	Endocrine, nutritional and metabolic diseases (E00–E90)
f.	Injury, poisoning and certain other consequences of external causes (S00–T98)
g.	Neoplasms (C00–D48)
h.	Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 
(R00–R99)

Source: NCCH 2000.
Table C.1:	Disease classifications used in regression modelling
Disease description	ICD-10 codes	
Infectious and parasitic diseases	A00–B99	
Neoplasms (cancers and tumours)	C00–D48	
Diseases of the blood and blood-forming organs and immunological disorders	D50–D89	
Endocrine, nutritional and metabolic diseases (excluding diabetes mellitus)	E00–E07, E15–E90	
Endocrine, nutritional and metabolic diseases : diabetes mellitus	E10–E14	
Mental and behavioural disorders: dementia and related disorders	F01–F03, G30–G32	
Mental and behavioural disorders (excluding dementia and related disorders) 	F04–F99	
Diseases of the nervous system	G00–G26, G35–G99	
Diseases of the eye and adnexa	H00–H59	
Diseases of the ear and mastoid process 	H60–H95	
Diseases of the circulatory system (excluding stroke and other cerebrovascular diseases, ischaemic heart diseases and diseases of the arteries)	I00–I15, I30–I52, I80–I99	
Diseases of the circulatory system: ischaemic heart diseases	I20–I25	
Diseases of the circulatory system: stroke	I60–I64	
Diseases of the circulatory system: cerebrovascular diseases (excluding stroke)	I65–I69	
Diseases of the circulatory system: diseases of the arteries	I70–I79	
Diseases of the respiratory system (excluding COPD and influenza and pneumonia)	J00–J06, J20–J40, J45–J99	
Diseases of the respiratory system: influenza and pneumonia	J10–J18	
Diseases of the respiratory system: COPD	J41–J44	
Diseases of the digestive system (excluding cirrhosis and other diseases of the liver)	K00–K67, K80–K93	
Diseases of the digestive system: cirrhosis and other diseases of the liver	K70–K76	
Diseases of the skin and subcutaneous tissue	L00–L99	
Diseases of the musculoskeletal system and connective tissue 	M00–M99	
Diseases of the genitourinary system (excluding kidney failure)	N00–N16, N20–N99	
Diseases of the genitourinary system: kidney failure	N17–N19	
Symptoms, signs and abnormal findings n.e.c.	R00–R09	
Injury caused by fall	S00–T98 and external cause of morbidity and mortality is in W00–W19	
Injury, poisoning and other consequences of external causes (excluding injury caused by fall)	S00–T98, except when external cause of morbidity and mortality is in 
W00–W19	
Factors influencing health status (excluding ‘Awaiting admission elsewhere’)	Z00–Z99 (excluding Z75.1)	
Factors influencing health status: awaiting admission elsewhere	Z75.1	

Appendix D: English proficiency groups
The English Proficiency (EP) Groups classification is used to indicate a migrant’s level of English proficiency using an English proficiency index, the person’s country of birth and the number of that country’s immigrants living in Australia (DIMA 2003). The EP index is defined as the percentage of recent immigrants (those entering in the 5 years before the Census) who speak English only or another language and good English. Good English is defined as those who reported at the Census that they spoke ‘English Only’ or spoke English ‘Very Well’ or ‘Well’ (DIMA 2003). The 2001 English proficiency groups are given in Table D.1 and were defined such that:
EP1 = All countries rating 98.5% or higher with at least 10,000 residents in Australia
EP2 = Countries rating 84.5% or higher on the EP index, other than those in EP1
EP3 = Countries rating 57.5% to less than 84.5%
EP4 = Countries rating less than 57.5%.
Table D.1:	English proficiency group classification
English proficiency group	Countries	
EP Group 1	Canada	United Kingdom	Zimbabwe	
	Ireland	United States of America		
	New Zealand	South Africa		
				
EP Group 2	Americas nfd	Brunei Darussalam	Dominica	
	Andorra	Bulgaria	Dominican Republic	
	Angola	Burkina Faso	Eastern Europe nfd	
	Antigua and Barbuda	Burundi	Equatorial Guinea	
	Aruba	Cameroon	Faeroe Islands	
	At Sea	Cape Verde	Falkland Islands	
	Australian ext. territories nec	Caribbean nfd	Fiji	
	Austria	Cayman Islands	Finland	
	Bahamas	Central African Republic	France	
	Bahrain	Central America nfd	French Guiana	
	Bangladesh	Chad 	French Polynesia	
	Barbados	Chilean Antarctic Territory	Gabon	
	Belgium	Comoros	Gambia	
	Belize	Congo, Democratic Republic of	Germany	
	Benin	Cook Islands	Ghana	
	Bermuda	Costa Rica	Gibraltar	
	Bhutan	Cote D’Ivoire	Greenland	
	Botswana	Czech Republic	Grenada	
	Brazil	Denmark	Guadeloupe	
			(continued)	

Table D.1 (continued):	English proficiency group classification
English proficiency group	Countries	
EP Group 2 (continued)	Guam	Nauru	Slovakia	
	Guatemala	Nepal 	Slovenia 	
	Guinea-Bissau 	Netherlands 	Solomon Islands 	
	Guyana 	Netherlands Antilles 	South America nec	
	Haiti 	New Caledonia 	Southern and East Africa nec	
	Holy See 	Niger 	Southern and East Africa nfd 	
	Iceland 	Nigeria 	Southern and Eastern Europe nfd	
	India 	Niue 	Southern Asia nfd	
	Indonesia	Norfolk Island 	Spain 	
	Israel 	North Africa nec	Sri Lanka 	
	Jamaica 	North Africa nfd 	St Helena 	
	Kenya 	Northern America nfd 	St Kitts and Nevis 	
	Kiribati 	Northern Europe nfd 	St Lucia 	
	Latvia	Northern Mariana Islands 	St Pierre and Miquelon	
	Lesotho 	Norway 	St Vincent and the Grenadines 	
	Liberia 	Oceania and Antarctica nfd	Suriname 	
	Liechtenstein 	Oman 	Swaziland 	
	Luxembourg 	Pakistan 	Sweden 	
	Madagascar 	Palau 	Switzerland 	
	Malawi	Panama	Tajikistan 	
	Malaysia	Papua New Guinea 	Tanzania 	
	Maldives 	Philippines	Tokelau	
	Mali 	Polynesia (excludes Hawaii) nec	Tonga 	
	Malta 	Polynesia (excludes Hawaii) nfd	Trinidad and Tobago 	
	Maritime South-East Asia nfd	Puerto Rico	Tunisia	
	Marshall Islands 	Qatar 	Turks and Caicos Islands 	
	Martinique 	Reunion 	Tuvalu 	
	Mauritania 	Rwanda 	Uganda 	
	Mauritius 	Samoa	United Arab Emirates 	
	Melanesia nfd	Samoa, American	Vanuatu 	
	Mexico	San Marino 	Venezuela 	
	Micronesia, Federated States of	Sao Tome and Principe 	Virgin Islands, British 	
	Monaco 	Saudi Arabia	Virgin Islands, United States 	
	Montserrat 	Senegal	Wallis and Futuna 	
	Morocco 	Seychelles 	Western Sahara	
	Mozambique 	Sierra Leone 	Zambia	
	Namibia 	Singapore 		
			(continued)	

Table D.1 (continued):	English proficiency group classification
English proficiency group	Countries	
EP Group 3 	Afghanistan 	Fmr Yugoslav Rep Macedonia (FYROM)	Moldova 	
	Albania 	Gaza Strip and West Bank	Mongolia 	
	Algeria	Georgia 	North Africa and the Middle East nfd	
	Argentina 	Greece 	Paraguay 	
	Armenia 	Honduras	Peru 	
	Belarus	Hong Kong (SAR of China)	Poland	
	Bolivia	Hungary 	Portugal	
	Bosnia and Herzegovina	Iran	Romania 	
	Burma (Myanmar) 	Iraq	Russian Federation 	
	Central and West Africa nfd	Italy 	Somalia	
	Chile	Japan	South Eastern Europe nfd	
	China (excl. SARs and Taiwan Province)	Jordan	South-East Asia nfd	
	Colombia	Kazakhstan	Sudan 	
	Croatia	Korea, Democratic People’s Rep of (North)	Syria 	
	Cuba 	Korea, Republic of (South)	Taiwan 	
	Cyprus	Kuwait	Thailand 	
	Djibouti	Kyrgyz Republic	Togo	
	Ecuador	Lebanon	Turkmenistan	
	Egypt	Libya 	Ukraine 	
	El Salvador 	Lithuania 	Uruguay 	
	Eritrea 	Macau (SAR of China)	Uzbekistan 	
	Estonia	Micronesia nfd	Yemen 	
	Ethiopia 	Middle East nfd	Yugoslavia, Federal Republic of	
				
EP Group 4	Antarctica nfd	East Timor	Southern Europe nfd	
	Azerbaijan	Guinea	Turkey	
	Cambodia	Japan and the Koreas nfd	Viet Nam	
	Central Asia nfd	Laos		
	Chinese Asia (includes Mongolia) nfd	Mainland South-East Asia nfd		
nfd	not further defined.
nec	not elsewhere classified.
SAR	special administrative region.
Source: DIMA 2003.

Appendix E: Logistic regression models for factors affecting admission into RAC from hospital
In this study, logistic regression models were used to determine which personal characteristics and hospital care and diagnostic information were important in predicting entry into RAC following discharge from hospital. In particular, we were interested in modelling the probability of:
•	RAC admission (rather than return to the community) following discharge from hospital (Model A), and
•	permanent RAC admission (rather than respite RAC admission) following discharge from hospital, given that the person will be entering RAC (Model B).
Both models used the following variables: 
•	age at admission
•	sex
•	state/territory of hospital admission
•	remoteness of usual residence
•	marital status (largely not reported for Queensland hospitals)
•	English Proficiency group, which is based on reported country of birth using the 2001 classification of countries into english proficiency groups (see Appendix D)
•	hospital sector
•	care type in hospital prior to discharge
•	hospital admission mode
•	length of hospital episode
•	principal diagnosis
•	presence or absence of specific diseases as additional diagnoses.
For this analysis, to identify factors associated with admission into RAC versus return to the community, hospital episodes that ended with either the death of the patient or a return to permanent RAC were excluded from the model fitting process. Models were fitted using unadjusted data.
It should be noted that there may be other factors associated with RAC admission for which we did not have information and so could not include these in the model. Further, it is not possible to infer causation from the results of the regression model, and this can only be done on the basis of other knowledge.
For both models, an overall Type I error rate of 5% was maintained by using a Bonferroni adjustment for multiple comparisons (Anderson et al. 1994). Consequently, only variables for which the statistical test had a p-value of less than 0.125% were included in the model.
Results for these models are presented in tables E.1, E.2 and E.3. A brief technical discussion of logistic regression and interpretation of results follows.
E.1	The model
The logistic regression model is expressed as an equation that estimates the probability of the event of interest and is of the form:

Logit (p) = (beta to the power of t)X
where logit(p) = ln[p over (1-p)]

p = probability of observing the event of interest (entering RAC for Model A and entering permanent RAC for model B)
beta is the vector of m parameter coefficients (one coefficient for each level of each categorical variable, one for each continuous variable and one for the intercept, minus the number of categorical variables); and  
X is the vector of covariates.
The regression analysis provides estimates of the effects of each of the variables included in the model while controlling for the effects of the other variables included in the model (Hosmer & Lemeshow 2000).
E.2	Predicted probabilities
The predicted probability of the event occurring can be calculated for a person with a particular set of characteristics by using the parameter estimates obtained from the logistic regression model in the equation

P[event/x=z] = exp[(sum over k+1 from {beta base k} to n)(sum over k+1 from {Z base k} to n)] over 1 + exp[(sum over k+1 from {beta base k} to n)(sum over k+1 from {Z base k} to n)]

Where P = probability of observing the event of interest (entering RAC for Model A and entering permanent RAC for model B)
Beta is the vector of m parameter coefficients; and  
Z is the vector of covariate values for the person of interest. 
The following example demonstrates how to calculate the predicted probability of a person entering RAC using the parameter estimates from Model A in Table E.3. Suppose we wish to calculate the predicted probability of admission into RAC from hospital for a person (Mary, say) with the following personal and hospital episode characteristics: 
•	female
•	84 years old at admission into hospital
•	widowed
•	born in Australia
•	usual residence in a major city
•	admitted to a public hospital in Victoria
•	receiving maintenance care
•	episode began with a statistical admission (change in care type)
•	episode lasted between 1 and 4 weeks
•	principal diagnosis in dementia and related disorders
•	additional diagnosis in diseases of the nervous system.
To calculate the predicted probability we use the relevant parameter estimates (Table E.3) and enter them into the above equation. Note that the intercept estimate must also be included. Variables whose value is the reference group in the model fitting process have a parameter value equal to 0, and age at admission in years is multiplied by the parameter estimate for age. If the parameter estimate for a variable is not significantly different to the reference group then the parameter is set to 0. 

The equation above then becomes
P{Mary being admitted to RAC] = exp(-11.45 + 0 + 0.08 x 84 + 0 + 0.34 + 0 + 0 + 0.88 + 0.45 + 1.35 + 2.36 + 0.43) over 1 + exp(-11.45 + 0 + 0.08 x 84 + 0 + 0.34 + 0 + 0 + 0.88 + 0.45 + 1.35 + 2.36 + 0.43)
= exp(1.08) over 1+ exp(1.08)
=2.95 over 3.95
=0.75

Therefore, a person like Mary with the above personal and hospital episode characteristics has a 75% predicted probability of being admitted to RAC on discharge from hospital. Consequently, she has a 25% predicted probability of returning to the community. This means that Mary’s odds of entry into RAC are 3 (0.75/0.25). Predicted probabilities for any other set of covariate values can be calculated in a similar manner.
E.3	Odds ratios
Odds ratios are calculated for each variable in the logistic regression model (Table E.1 and Table E.2). The odds ratio is a relative measure which compares the odds of people in a particular group (for example, men) experiencing an event, for example admission into RAC, with the odds of people in another group (for example, women) experiencing the event. The odds of an event occurring are defined as:

Odds = Probability y of event occurring over probability y of event not occurring
=p over 1-p
The odds ratio is then defined as:
Odds ratio = Odds for people in group 2 over Odds for people in group 1.
with group 1 being the reference group.
Returning to our example with Mary above, if someone else, say John, had an odds of RAC entry of 1.5 (0.6/0.4), then the odds ratio for Mary compared with John is 2 (3/1.5). 
An odds ratio of 1 means that the odds of the event occurring is equal in both groups. An odds ratio of greater than 1 means that the odds of the event occurring is higher for people in group 2 than in group 1. Conversely, an odds ratio of less than 1 means that odds of the event occurring is less for people in group 2 than in group 1. More specifically, an odds ratio of 1.3 means that the odds for people in group 2 are 30% higher than the odds for people in group 1. An odds ratio of 0.6 means that the odds for people in group 2 are 40% lower than the odds for people in group 1.
If the probability of the event happening is small, say less than 10%, the odds ratio is approximately equal to the relative risk. That is, an odds ratio of 1.25 can be interpreted as meaning that the probability of the event occurring for people in group 2 is 25% more than the probability of the event occurring for people in group 1. 
In logistic regression, we obtain the odds ratio for a variable relative to the reference group, controlling for the presence of all other variables. For example, men discharged from hospital have an odds ratio of entering RAC of 0.91 (Table E.1). This means that the odds of RAC admission for men are 9% lower than the odds for women. Since the probability of people admitted to RAC from hospital is small (3%), we can also say that the probability of men being admitted to RAC from hospital is approximately 9% lower than the probability of women being admitted to RAC.
For integer variables (for example, age) the interpretation of odds ratios is slightly different, with the odds ratio comparing the odds of the event occurring for a unit increment in the variable. For example, an odds ratio for age at hospital admission of 1.08 indicates that with each extra year of age at hospital admission, the odds of entering RAC increases by 8%.
Odds ratios are a commonly presented result from logistic regression. Our discussion of the logistic regression concentrates on predicted probabilities, and this explanation of odds ratios is presented for completeness.  

Table E.1:	Logistic regression results: factors affecting admission into RAC, 2001–02 (Model A)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering RAC rather than returning to the community, based on reference person(b)	
						Per cent	
Sex	Female (reference)	18	1.00		. .	0.4	
	Male		0.91	***	(0.88–0.94)	0.3	
Age	Increments of one year	4	1.08	***	(1.08–1.08)	65 years: 0.2
 75 years: 0.4
 85 years: 0.8
 95 years: 1.8	
State/territory of hospital admission	New South Wales (reference)	7	1.00		. .	0.4	
	Victoria		0.66	***	(0.63–0.69)	0.3	
	Queensland		0.60	***	(0.55–0.65)	0.2	
	Western Australia		0.63	***	(0.60–0.67)	0.2	
	South Australia		0.98		(0.93–1.03)	‡0.4	
	Tasmania		0.49	***	(0.44–0.55)	0.2	
	Australian Capital Territory		0.65	***	(0.55–0.76)	0.2	
	Northern Territory		0.63	*	(0.42–0.91)	0.2	
Region of usual residence	Major cities (reference)	22	1.00		. .	0.4	
	Inner regional		0.98		(0.94–1.02)	‡0.4	
	Outer regional		0.95		(0.90–1.00)	‡0.4	
	Remote		0.78	**	(0.67–0.91)	0.3	
	Very remote		0.79		(0.60–1.01)	‡0.4	
	Missing/unknown		0.41	***	(0.27–0.59)	0.2	
Marital  status	Married/de facto (reference)	9	1.00		. .	0.4	
	Never married		1.91	***	(1.80–2.04)	0.7	
	Widowed		1.40	***	(1.35–1.46)	0.5	
	Divorced		1.61	***	(1.47–1.75)	0.6	
	Separated		1.46	***	(1.28–1.66)	0.6	
	Missing/Unknown		1.70	***	(1.57–1.83)	0.6	
EP group	Australia/EP 1 (reference)	14	1.00		. .	0.4	
	EP group 2		0.86	***	(0.81–0.93)	0.3	
	EP group 3		0.72	***	(0.68–0.76)	0.3	
	EP group 4		0.62	**	(0.46–0.83)	0.2	
	EP group unknown		0.70	***	(0.63–0.78)	0.3	
Hospital sector	Public (reference)	13	1.00		. .	0.4	
	Private		0.74	***	(0.72–0.77)	0.3	
					(continued)	

Table E.1 (cont’d):	Logistic regression results: factors affecting admission into RAC, 2001–02 (Model A)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering RAC rather than returning to the community, based on reference person(b)	
						Per cent	
Care type in hospital

	Acute (reference)	8	1.00		. .	0.4	
	Rehabilitation		0.55	***	(0.51–0.60)	0.2	
	Palliative		2.79	***	(2.47–3.15)	1.1	
	GEM		0.97		(0.89–1.06)	‡0.4	
	Psychogeriatric		0.95		(0.79–1.13)	‡0.4	
	Maintenance		1.56	***	(1.43–1.71)	0.6	
	Other/unknown		1.68	***	(1.50–1.87)	0.6	
Admission mode	Other (reference)	6	1.00		. .	0.4	
	Transfer from another hospital		1.56	***	(1.49–1.64)	0.6	
	Statistical admission		2.40	***	(2.26–2.55)	0.9	
	Unknown		0.53	***	(0.38–0.72)	0.2	
Length of hospital episode	Less than one week(reference)	3	1.00		. .	0.4	
	1–<4 weeks		3.87	***	(3.71–4.03)	1.5	
	4–<8 weeks		11.65	***	(11.05–12.28)	4.3	
	8–<12 weeks		17.42	***	(16.00–18.98)	6.2	
	12 weeks or more		19.66	***	(17.72–21.81)	7.0	
Principal diagnosis in hospital

	Neoplasms (cancers and tumours) (reference)	1	1.00		. .	0.4	
	Factors influencing health status: awaiting admission elsewhere 		14.27	***	(12.8–15.91)	5.2	
	Mental and behavioural disorders: dementia and related disorders		10.55	***	(9.48–11.73)	3.9	
	Diseases of the nervous system 		3.73	***	(3.41–4.07)	1.4	
	Diseases of the circulatory system: Stroke		3.06	***	(2.78–3.37)	1.2	
	Mental and behavioural disorders (excluding dementia and related disorders)		2.04	***	(1.84–2.25)	0.8	
	Injury caused by fall		2.03	***	(1.87–2.21)	0.8	
	Symptoms, signs and abnormal findings n.e.c.		1.67	***	(1.53–1.82)	0.6	
	Endocrine, nutritional and metabolic diseases (excluding diabetes mellitus)		1.58	***	(1.35–1.83)	0.6	
	Diseases of the circulatory system: cerebrovascular disease (excluding stroke)		1.43	**	(1.11–1.81)	0.5	
	Factors influencing health status (excl. ‘Awaiting admission elsewhere’)		1.37	***	(1.25–1.49)	0.5	
				(continued)	
Table E.1 (cont’d):	Logistic regression results: factors affecting admission into RAC, 2001–02 (Model A)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering RAC rather than returning to the community, based on reference person(b)	
						Per cent	
Principal diagnosis in hospital (continued)

	Diseases of the genitourinary system: kidney failure 		1.34	**	(1.10–1.63)	0.5	
	Diseases of the respiratory system: COPD 		1.30	***	(1.17–1.44)	0.5	
	Diseases of the digestive system: Cirrhosis and other diseases of the liver 		1.21		(0.84–1.71)	‡0.4	
	Diseases of the skin and subcutaneous tissue 		1.14	*	(1.01–1.29)	0.4	
	Diseases of the genitourinary system (excluding kidney failure)		1.12	*	(1.01–1.24)	0.4	
	Endocrine, nutritional and metabolic diseases: diabetes mellitus 		1.10		(0.96–1.27)	‡0.4	
	Diseases of the respiratory system (excluding COPD and influenza and pneumonia)		1.06		(0.94–1.19)	‡0.4	
	Diseases of the respiratory system: Influenza and pneumonia		1.01		(0.90–1.14)	‡0.4	
	Diseases of the musculoskeletal system and connective tissue 		1.00		(0.91–1.10)	‡0.4	
	Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)		0.96		(0.88–1.04)	‡0.4	
	Infectious and parasitic diseases 		0.88		(0.74–1.04)	‡0.4	
	Injury, poisoning and other consequences of external causes (excluding injury caused by fall)		0.82	***	(0.72–0.92)	0.3	
	Diseases of the blood and blood-forming organs and immunological disorders 		0.77	**	(0.63–0.92)	0.3	
	Diseases of the digestive system (excluding cirrhosis and other diseases of the liver)		0.68	***	(0.61–0.75)	0.3	
	Diseases of the circulatory system: diseases of the arteries		0.65	***	(0.54–0.78)	0.2	
	Other/unknown 		0.62		(0.33–1.07)	‡0.4	
	Diseases of the ear and mastoid process 		0.58	*	(0.35–0.90)	0.2	
	Diseases of the eye and adnexa		0.55	***	(0.42–0.72)	0.2	
	Diseases of the circulatory system: ischaemic heart disease		0.55	***	(0.49–0.62)	0.2	
						(continued)	
Table E.1 (cont’d):	Logistic regression results: factors affecting admission into RAC, 2001–02 (Model A)
Variable(a)	Level	Order of entry into model	Odds ratio 
(95% confidence interval)	Predicted probability of entering RAC rather than returning to the community, based on reference person(b)	
						Per cent	
Additional diagnosis: Factors influencing health status: awaiting admission elsewhere	Absent (reference)	2	1.00		. .	0.4	
	Present		11.90	***	(11.19–12.66)	4.3	
Additional diagnosis: Mental and behavioural disorders: dementia and related disorders	Absent (reference)	5	1.00		. .	0.4	
	Present		3.21	***	(3.08–3.35)	1.2	
Additional diagnosis: Mental and behavioural disorders (excluding dementia and related disorders)	Absent (reference)	11	1.00		. .	0.4	
	Present		1.75	***	(1.66–1.84)	0.7	
Additional diagnosis: Diseases of the nervous system	Absent (reference)	10	1.00		. .	0.4	
	Present		1.54	***	(1.47–1.60)	0.6	
Additional diagnosis: Symptoms, signs and abnormal findings n.e.c.	Absent (reference)	12	1.00		. .	0.4	
	Present		1.44	***	(1.39–1.49)	0.5	
Additional diagnosis: Diseases of the skin and subcutaneous tissue	Absent (reference)	15	1.00		. .	0.4	
	Present		1.36	***	(1.29–1.43)	0.5	
Additional diagnosis: Diseases of the genitourinary system (excluding kidney failure)	Absent (reference)	16	1.00		. .	0.4	
	Present		1.24	***	(1.18–1.30)	0.5	
Additional diagnosis: Diseases of the circulatory system: stroke	Absent (reference)	20	1.00		. .	0.4	
	Present		1.23	***	(1.13–1.34)	0.5	
Additional diagnosis: Diseases of the respiratory system: COPD	Absent (reference)	19	1.00		. .	0.4	
	Present		1.21	***	(1.14–1.28)	0.5	
Additional diagnosis: Diseases of the genitourinary system: kidney failure	Absent (reference)	21	1.00		. .	0.4	
	Present		1.19	***	(1.12–1.26)	0.5	
Additional diagnosis: Infectious and parasitic diseases	Absent (reference)	23	1.00		. .	0.4	
	Present		1.11	***	(1.06–1.16)	0.4	
Additional diagnosis: Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)	Absent (reference)	24	1.00		. .	0.4	
	Present		0.93	***	(0.89–0.96)	0.4	
Additional diagnosis: Unknown/other	Absent (reference)	17	1.00		. .	0.4	
	Present		0.78	***	(0.73–0.83)	0.3	
*	Statistically significantly different from reference group at 5% level.
**       Statistically significantly different from reference group at 1% level.
***	Statistically significantly different from reference group at 0.1% level.
‡	Not significantly different to reference group and therefore predicted probability is the same as for the reference group.
. .    	Not applicable to the model.
(a)	To achieve an overall Type I error rate of 5%, variables were included in the final model if they had a p-value less than 0.125%, which was calculated using a Bonferroni adjustment for 40 multiple comparisons. All principal diagnosis diseases were tested for inclusion in the final model as additional diagnoses. Several interactions (for example, age by sex) were tested but found to be not significant at the 0.125% level.
(b)	The predicted probabilities relate to a person with characteristics the same as those of the ‘reference’ person except for the differences in the single variable whose effect is being analysed. The ‘reference’ person for Model A is 75 years old years old at admission, female, married/de facto, living in New South Wales, born in Australia or an EP group 1 country, usually residing in a major city, admitted to a public hospital with a non-statistical and non-transfer admission, receiving acute hospital care, in hospital for less than 1 week with a principal diagnosis of neoplasms (see Box 5.1).
Table E.2:	Logistic regression results: factors affecting admission into permanent RAC, 2001–02 (Model B)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering permanent rather than respite RAC, based on reference person(b)	
						Per cent	
Sex	. .	. .	. .		. .	. .	
Age at admission	Increments of one year	10	1.02	***	(1.02–1.03)	 65 years: 51.1
 75 years: 56.9
 85 years: 62.5
 95 years: 67.7	
State/territory of hospital admission	New South Wales (reference)	6	1.00		. .	62.5	
	Victoria		1.62	***	(1.48–1.77)	73.0	
	Queensland		1.21	***	(1.10–1.32)	66.7	
	Western Australia		0.78	***	(0.70–0.88)	56.6	
	South Australia		0.85	**	(0.77–0.94)	58.6	
	Tasmania		4.42	***	(3.33–5.94)	88.0	
	Australian Capital Territory		0.49	***	(0.36–0.66)	44.7	
	Northern Territory		1.07		(0.53–2.22)	‡62.5	
Region of usual residence	Major cities (reference)	5	1.00		. .	62.5	
	Inner regional		0.56	***	(0.52–0.60)	48.2	
	Outer regional		0.47	***	(0.43–0.52)	44.0	
	Remote		0.43	***	(0.32–0.58)	41.6	
	Very remote		0.44	**	(0.26–0.73)	42.0	
	Missing/unknown		0.70		(0.33–1.51)	‡62.5	
Hospital sector	Public (reference)	9	1.00		. .	62.5	
	Private		0.69	***	(0.64–0.74)	53.3	
Care type in hospital

	Acute (reference)	1	1.00		. .	62.5	
	Rehabilitation		0.93		(0.80–1.09)	‡62.5	
	Palliative		2.33	***	(1.78–3.10)	79.5	
	GEM		1.99	***	(1.64–2.43)	76.8	
	Psychogeriatric		1.06		(0.76–1.51)	‡62.5	
	Maintenance		1.48	***	(1.27–1.72)	71.1	
	Other/unknown		2.17	***	(1.68–2.83)	78.3	
Admission mode	Other (reference)	12	1.00		. .	62.5	
	Transfer from another hospital		1.19	***	(1.08–1.30)	69.8	
	Statistical admission		1.39	***	(1.24–1.56)	72.4	
	Unknown		1.58		(0.75–3.74)	‡62.5	
				(continued)	
Table E.2 (continued):	Logistic regression results: factors affecting admission into permanent RAC, 2001–02 (Model B)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering permanent rather than respite RAC, based on reference person(b)	
						Per cent	
Length of hospital episode	Less than one week(reference)	2	1.00		. .	49.5	
	1–<4 weeks		1.70	***	(1.56–1.84)	62.5	
	4–<8 weeks		2.91	***	(2.64–3.22)	74.1	
	8–<12 weeks		4.30	***	(3.65–5.08)	80.8	
	12 weeks or more		6.39	***	(5.21–7.90)	86.2	
Principal diagnosis in hospital	Neoplasms (cancers and tumours) (reference)	3	1.00		. .	62.5	
	Diseases of the digestive system: cirrhosis and other diseases of the liver		2.09		(0.90–5.74)	‡62.5	
	Diseases of the circulatory system: stroke		1.79	***	(1.45–2.23)	74.9	
	Mental and behavioural disorders: dementia and related disorders		1.70	***	(1.39–2.07)	73.8	
	Factors influencing health status: awaiting admission elsewhere		1.66	***	(1.36–2.03)	73.4	
	Diseases of the nervous system		1.26	*	(1.04–1.52)	67.6	
	Diseases of the ear and mastoid process		1.18		(0.42–3.70)	‡62.5	
	Diseases of the genitourinary system (excluding kidney failure)		1.01		(0.81–1.27)	‡62.5	
	Diseases of the circulatory system: cerebrovascular disease (excluding stroke)		0.91		(0.57–1.50)	‡62.5	
	Endocrine, nutritional and metabolic diseases (excluding diabetes mellitus)		0.91		(0.67–1.24)	‡62.5	
	Diseases of the genitourinary system: kidney failure		0.90		(0.60–1.39)	‡62.5	
	Diseases of the respiratory system: COPD		0.88		(0.71–1.09)	‡62.5	
	Diseases of the circulatory system: diseases of the arteries		0.88		(0.58–1.34)	‡62.5	
	Symptoms, signs and abnormal findings n.e.c.		0.86		(0.72–1.03)	‡62.5	
	Diseases of the eye and adnexa 		0.80		(0.45–1.41)	‡62.5	
	Diseases of the respiratory system (excluding COPD and influenza and pneumonia)		0.80		(0.62–1.02)	‡62.5	
	Diseases of the skin and subcutaneous tissue 		0.73	*	(0.57–0.95)	55.0	
	Diseases of the respiratory system: influenza and pneumonia		0.73	**	(0.57–0.92)	54.7	
	Endocrine, nutritional and metabolic diseases : diabetes mellitus		0.70	*	(0.52–0.93)	53.7	
	Injury caused by fall		0.68	***	(0.57–0.80)	53.0	
	Diseases of the blood and blood-forming organs and immunological disorders		0.65	*	(0.44–0.96)	52.0	
	Mental and behavioural disorders (excluding dementia and related disorders)		0.64	***	(0.52–0.78)	51.5	
				(continued)
	
Table E.2 (continued):	Logistic regression results: factors affecting admission into permanent RAC, 2001–02 (Model B)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering permanent rather than respite RAC, based on reference person(b)	
						Per cent	
Principal diagnosis in hospital (continued)

	Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)		0.63	***	(0.53–0.76)	51.3	
	Infectious and parasitic diseases		0.59	**	(0.42–0.83)	49.6	
	Diseases of the digestive system (excluding cirrhosis and other diseases of the liver)		0.59	***	(0.47–0.73)	49.4	
	Factors influencing health status (excluding ‘Awaiting admission elsewhere’)		0.55	***	(0.46–0.66)	47.8	
	Diseases of the musculoskeletal system and connective tissue		0.52	***	(0.43–0.63)	46.3	
	Diseases of the circulatory system: ischaemic heart disease		0.49	***	(0.38–0.63)	44.7	
	Injury, poisoning and other consequences of external causes (excluding injury caused by fall)		0.47	***	(0.37–0.61)	44.1	
	Other/unknown		0.45		(0.13–1.59)	‡62.5	
Additional diagnosis: Factors influencing health status: awaiting admission elsewhere	Absent (reference)	4	1.00		. .	62.5	
	Present		2.15	***	(1.96–2.37)	78.2	
Additional diagnosis: Mental and behavioural disorders: dementia and related disorders	Absent (reference)	7	1.00		. .	62.5	
	Present		1.72	***	(1.59–1.85)	74.1	
Additional diagnosis: Diseases of the circulatory system: stroke	Absent (reference)	14	1.00		. .	62.5	
	Present		1.60	***	(1.36–1.89)	72.7	
Additional diagnosis: Diseases of the genitourinary system: kidney failure	Absent (reference)	15	1.00		. .	62.5	
	Present		1.37	***	(1.22–1.54)	69.5	
						(continued)	
Table E.2 (continued):	Logistic regression results: factors affecting admission into permanent RAC, 2001–02 (Model B)
Variable(a)	Level	Order of entry into model	Odds ratio (95% confidence interval)	Predicted probability of entering permanent rather than respite RAC, based on reference person(b)	
						Per cent	
Additional diagnosis: Symptoms, signs and abnormal findings n.e.c.	Absent (reference)	8	1.00		. .	62.5	
	Present
		1.34
	***	(1.26–1.43)
	69.1
	
Additional diagnosis: Diseases of the circulatory system: Cerebrovascular disease (excluding stroke)	Absent (reference)	16	1.00		. .	62.5	
	Present		1.29	***	(1.13–1.47)	68.2	
Additional diagnosis: Diseases of the genitourinary system (excluding kidney failure)	Absent (reference)	17	1.00		. .	62.5	
	Present		1.28	***	(1.17–1.39)	68.0	
Additional diagnosis: Diseases of the nervous system	Absent (reference)	11	1.00		. .	62.5	
	Present		1.26	***	(1.16–1.37)	67.7	
Additional diagnosis: Diseases of the skin and subcutaneous tissue	Absent (reference)	18	1.00		. .	62.5	
	Present		1.21	***	(1.10–1.34)	66.9	
*		Statistically significantly different from reference group at 5% level.
**		Statistically significantly different from reference group at 1% level.
***		Statistically significantly different from reference group at 0.1% level.
‡		Not significantly different to reference group and therefore predicted probability is the same as for the reference group.
. .  		Not applicable to the model.
(a)	To achieve an overall Type I error rate of 5%, variables were included in the final model if they had a p-value less than 0.125%, which was calculated using a Bonferroni adjustment for 40 multiple comparisons. All principal diagnosis diseases were tested for inclusion in the final model as additional diagnoses. Variables indicating marital status and EP group were tested for inclusion in the final model but were not statistically significant at the 0.125% level. Several interactions (for example, age by sex) were tested but found to be not significant at the 0.125% level. Sex was included in the final model, despite having a significance level higher than 0.125%, in order to control for the effects of sex.
(b)	The predicted probabilities relate to a person with characteristics the same as those of the ‘reference’ person except for the differences in the single variable whose effect is being analysed. The ‘reference’ person for Model B is 85 years old years old at admission, female, living in New South Wales, usually residing in a major city, admitted to a public hospital with a non-statistical and non-transfer admission, receiving acute hospital care, in hospital for more than 1 week and less than 4 weeks with a principal diagnosis of neoplasms (see Box 5.2).
Table E.3:	Logistic regression results: parameter estimates for Model A and Model B
Variable(a)	Level	Model A
 Admitted to RAC rather than return to community		Model B
Admitted to permanent rather than respite RAC	
		Parameter estimates	
Intercept	. .	–11.45	***		–1.99	***	
Sex	Female (reference)	0.00			0.00		
	Male	–0.09	***		0.08	*	
Age	Increments of one year	0.08	***		0.02	***	
State/territory of hospital admission	New South Wales (reference)	0.00			0.00		
	Victoria	–0.42	***		0.48	***	
	Queensland	–0.52	***		0.19	***	
	Western Australia	–0.46	***		–0.24	***	
	South Australia	–0.02			–0.16	**	
	Tasmania	–0.71	***		1.49	***	
	Australian Capital Territory	–0.44	***		–0.72	***	
	Northern Territory	–0.46	*		0.07		
Region of usual residence	Major cities (reference)	0.00			0.00		
	Inner regional	–0.02			–0.58	***	
	Outer regional	–0.05			–0.75	***	
	Remote	–0.24	**		–0.85	***	
	Very remote	–0.23			–0.83	*	
	Missing/unknown	–0.90	***		–0.36		
Marital  status	Married/de facto (reference)	0.00			. .		
	Never married	0.65	***		. .		
	Widowed	0.34	***		. .		
	Divorced	0.47	***		. .		
	Separated	0.38	***		. .		
	Missing/Unknown	0.53	***		. .		
EP group	Australia/EP 1 (reference)	0.00			. .		
	EP group 2	–0.15	***		. .		
	EP group 3	–0.33	***		. .		
	EP group 4	–0.47	**		. .		
	EP group unknown	–0.35	***		. .		
Hospital sector	Public (reference)	0.00			0.00		
	Private	–0.30	***		–0.38	***	
Admission mode	Other (reference)	0.00			0.00		
	Transfer from another hospital	0.45	***		0.17	***	
	Statistical admission	0.88	***		0.33	***	
	Unknown	–0.64	***		0.46		
					(continued)	
Table E.3 (continued):	Logistic regression results: parameter estimates for Model A and Model B
Variable(a)	Level	Model A
 Admitted to RAC rather than return to community		Model B
Admitted to permanent rather than respite RAC	
		Parameter estimates	
Care type in hospital

	Acute (reference)	0.00			0.00		
	Rehabilitation	–0.60	***		–0.07		
	Palliative	1.03	***		0.85	***	
	GEM	–0.03			0.69	***	
	Psychogeriatric	–0.05			0.06		
	Maintenance	0.45	***		0.39	***	
	Other/unknown	0.52	***		0.77	***	
Length of hospital episode	Less than one week(reference)	0.00			0.00		
	1–<4 weeks	1.35	***		0.53	***	
	4–<8 weeks	2.46	***		1.07	***	
	8–<12 weeks	2.86	***		1.46	***	
	12 weeks or more	2.98	***		1.85	***	
Principal diagnosis in hospital

	Neoplasms (cancers and tumours) (reference)	0.00			0.00		
	Factors influencing health status: awaiting admission elsewhere 	2.66	***		0.51	***	
	Mental and behavioural disorders: dementia and related disorders	2.36	***		0.53	***	
	Diseases of the nervous system 	1.32	***		0.23	*	
	Diseases of the circulatory system: stroke	1.12	***		0.58	***	
	Mental and behavioural disorders (excluding dementia and related disorders)	0.71	***		–0.45	***	
	Injury caused by fall	0.71	***		–0.39	***	
	Symptoms, signs and abnormal findings n.e.c.	0.51	***		–0.15		
	Endocrine, nutritional and metabolic diseases (excluding diabetes mellitus)	0.45	***		–0.10		
	Diseases of the circulatory system: cerebrovascular disease (excluding stroke)	0.36	**		–0.09		
	Factors influencing health status (excluding ‘Awaiting admission elsewhere’)	0.31	***		–0.60	***	
	Diseases of the genitourinary system: kidney failure	0.29	**		–0.10		
	Diseases of the respiratory system: COPD	0.26	***		–0.13		
	Diseases of the digestive system: Cirrhosis and other diseases of the liver	0.19			0.74		
	Diseases of the skin and subcutaneous tissue 	0.13	*		–0.31	*	
	Diseases of the genitourinary system (excluding kidney failure)	0.11	*		0.01		
	Endocrine, nutritional and metabolic diseases : diabetes mellitus 	0.10			–0.36	*	
			(continued)	
Table E.3 (continued):	Logistic regression results: parameter estimates for Model A and Model B
Variable(a)	Level	Model A
 Admitted to RAC rather than return to community		Model B
Admitted to permanent rather than respite RAC	
		Parameter estimates	
Principal diagnosis in hospital (continued)
	Diseases of the respiratory system (excluding COPD and influenza and pneumonia)	0.06			–0.23		
	Diseases of the respiratory system: influenza and pneumonia	0.01			–0.32	**	
	Diseases of the musculoskeletal system and connective tissue 	0.00			–0.66	***	
	Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)	–0.05			–0.46	***	
	Infectious and parasitic diseases 	–0.13			–0.53	**	
	Injury, poisoning and other consequences of external causes (excluding injury caused by fall)	–0.20	***		–0.75	***	
	Diseases of the blood and blood-forming organs and immunological disorders 	–0.27	**		–0.43	*	
	Diseases of the digestive system (excluding cirrhosis and other diseases of the liver)	–0.39	***		–0.53	***	
	Diseases of the circulatory system: diseases of the arteries	–0.43	***		–0.13		
	Other/unknown 	–0.47			–0.80		
	Diseases of the ear and mastoid process 	–0.55	*		0.17		
	Diseases of the eye and adnexa	–0.59	***		–0.22		
	Diseases of the circulatory system: ischaemic heart disease	–0.60	***		–0.72	***	
Additional diagnosis: Factors influencing health status: awaiting admission elsewhere	Absent (reference)	0.00			0.00		
	Present	2.48	***		0.77	***	
Additional diagnosis: Mental and behavioural disorders: dementia and related disorders	Absent (reference)	0.00			0.00		
	Present	1.17	***		0.54	***	
Additional diagnosis: Mental and behavioural disorders (excluding dementia and related disorders)	Absent (reference)	0.00			. .		
	Present	0.56	***		. .		
Additional diagnosis: Diseases of the nervous system	Absent (reference)	0.00			0.00		
	Present	0.43	***		0.23	***	
Additional diagnosis: Symptoms, signs and abnormal findings n.e.c.	Absent (reference)	0.00			0.00		
	Present	0.36	***		0.29	***	
Additional diagnosis: Diseases of the skin and subcutaneous tissue	Absent (reference)	0.00			0.00		
	Present	0.30	***		0.19	***	
					(continued)	
Table E.3 (continued):	Logistic regression results: parameter estimates for Model A and Model B
Variable(a)	Level	Model A
 Admitted to RAC rather than return to community		Model B
Admitted to permanent rather than respite RAC	
		Parameter estimates	
Additional diagnosis: Diseases of the genitourinary system (excluding kidney failure)	Absent (reference)	0.00			0.00		
	Present	0.21	***		0.24	***	
Additional diagnosis: Diseases of the circulatory system: stroke	Absent (reference)	0.00			0.00		
	Present	0.21	***		0.47	***	
Additional diagnosis: Diseases of the circulatory system: cerebrovascular disease (excluding stroke)	Absent (reference)	. .			0.00		
	Present	 . .			0.25	***	
Additional diagnosis: Diseases of the respiratory system: COPD	Absent (reference)	0.00			. .		
	Present	0.19	***		. .		
Additional diagnosis: Diseases of the genitourinary system: kidney failure	Absent (reference)	0.00			0.00		
	Present	0.17	***		0.31	***	
Additional diagnosis: Infectious and parasitic diseases	Absent (reference)	0.00			. .		
	Present	0.11	***		. .		
Additional diagnosis: Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)	Absent (reference)	0.00			. .		
	Present	–0.08	***		. .		
Additional diagnosis: Unknown/other	Absent (reference)	0.00			. .		
	Present	–0.25	***		. .		
*	Statistically significantly different from reference group at 5% level.
**   	Statistically significantly different from reference group at 1% level.
***	Statistically significantly different from reference group at 0.1% level.
. .    	Not applicable to the model.
(a)	To achieve an overall Type I error rate of 5%, variables were included in the final model if they had a p-value less than 0.125%, which was calculated using a Bonferroni adjustment for 40 multiple comparisons. Variables indicating marital status, location of ACAT assessment, English proficiency group, first time in RAC, hospital sector and presence of specific diseases as additional diagnoses were tested for inclusion in the final model but were not statistically significant at the 0.125% level. Several interactions (for example, age by sex) were tested but found to be not significant at the 0.125% level.

Appendix F: Survival analysis of people entering permanent RAC
In this study, survival analysis techniques were used to determine which personal characteristics and hospital diagnostic history were associated with time until death since entering permanent RAC. To be included in the analysis, admissions to permanent RAC had to occur between 1 July and 31 December 2001 inclusive. The survival time was calculated as the time from entry into permanent RAC until the time of death (determined from RAC records). A person’s date of death information may not have been available (and was therefore right censored) for two reasons:
•	The person had left RAC, for example when discharged to hospital, and so may have died while not in RAC: we do not have any information on the date of death of these people, but have a ‘last seen’ date—their date of discharge from RAC. This censored date was used in the survival analysis.
•	The person was still living in RAC: the RAC data was derived from a 2004 snapshot of ACCMIS, and, consequently, date of death was generally available only for people who had died in RAC before 30 June 2004. People who had not died in RAC by 30 June 2004 were therefore known to have been alive on 30 June 2004, so their survival data was censored at this date.
A Cox proportional hazards regression model was fitted to the survival times. This investigates the effect of variables upon the time taken for an event to occur. In our model, the event is death. An outline of the theory behind the Cox proportional hazards regression model can be found in Klein & Moeschberger 1997. 
The Cox proportional hazards regression model fits a hazard function, h(t), for any individual case at time t, such that 
H(t) = (h to the base 0)(t)exp[(beta to the power of t)X]

Where
(h to the base 0)(t) is the baseline hazard function 
Beta is the vector of parameter coefficients, and  
X is the vector of covariates.
The hazard function approximates the probability of the individual dying in the next time interval. The survival function, S(t), gives the probability of an individual surviving beyond time t, and is related to the hazard function such that
S(t) = exp[-integral from t to 0 with respect to h(u)du)]
.
The Cox proportional hazards regression model allows the estimation of hazard ratios, which compare the hazard functions of two individuals with covariate values Z and Z*, such that

h(t/Z) over h(t/Z*) = h to the base 0(t)exp[sum over k from k=1 to p of (beta to the base k)(Z to the base k) over h to the base 0(t)exp[sum over k from k=1 to p of (beta to the base k)(Z* to the base k)
=exp[sum over k from k=1 to p of beta to the base k(Z to the base k minus Z* to the base k)].
This measure is a constant and is known as the hazard ratio or relative risk. That is, it is the relative risk of an individual with covariate values Z having the event (in our case, death) in the next time period compared with an individual with covariate values Z*. For example, if the hazard ratio of men versus women is 1.3, this means that men are 30% more likely to die during the next time interval than women. 
Covariates used in Cox proportional hazards regression models can be quantitative or categorical. When categorical variables are used, a reference group must be specified and this is the group to which all other levels of the categorical variable are compared. For the current study, the reference group was generally selected because it was the most common group (for example, female was the reference group for sex). However, in a number of cases a reference group was selected because it had the shortest or longest survival times (for example, neoplasms had the shortest survival times amongst principal diagnoses). For integer variables (for example, age at admission) the interpretation of the hazard ratio is slightly different, with the hazard ratio comparing the hazard functions for a unit increment in the variable. For example, a hazard ratio of 1.05 for age at admission indicates that with each year increase in age at admission, there is an associated 5% increase in the probability of dying on a given day.
The estimated hazard ratios obtained from the regression model estimate the relative risk of death between two levels of the variable specified, while controlling for the presence of all other variables in the model. It should be noted that, as with all modelling, there may be other factors associated with survival following RAC admission for which we did not have information and so could not include in the model. Further, it is not possible to infer causation from the results of the model, and this can only be done on the basis of other knowledge.
Two models were used to examine differences in the relative risk of death for people entering permanent RAC:
•	Model C: All people admitted to permanent RAC between 1 July and 31 December 2001 inclusive, using the variables state/territory of admission, age at admission, sex, marital status, EP group, region of RAC facility, source of admission (hospital or community), first time in RAC, RCS category on admission and location of ACAT assessment. Because we were testing 10 variables for inclusion into the model, an overall Type I error rate of 5% was maintained by using a Bonferroni adjustment (a Type I error is the probability of obtaining a statistically significant result when in fact, it is a non-significant result). Consequently, variables for which the statistical test had a p-value of less than 0.5% were included in the model. 
•	Model D: People entering permanent RAC from hospital between 1 July and 31 December 2001 inclusive, using the variables state/territory of admission, age at admission, sex, marital status, EP group, region of RAC facility, first time in RAC, RCS category on admission, location of ACAT assessment, hospital care type prior to discharge, length of hospital episode prior to discharge, principal diagnosis disease category and presence of other disease diagnoses. As in Model A, an overall Type I error rate of 5% was maintained by using a Bonferroni adjustment. Variables for which the statistical test had a p-value of less than 0.12% were therefore included in the model. 
Results for these models are presented in Table F.1 and Table F.2. The models were fitted using unadjusted data. 
Table F.1:	Survival analysis results Model C: all people entering permanent RAC, 
1 July–31 December 2001
Variable(a)	Level	Order of entry into model	Hazard ratio 
(95% confidence interval)	Number in group	Censored observations	
						N	Per cent	
Sex	Female (reference)	2	1.00		. .	15,508	53.0	
	Male		1.53	***	(1.47 – 1.59)	7,581	41.7	
Age	Year	3	1.03	***	(1.03 – 1.03)	23,089	49.3	
Entry into RAC	Moving from community (including from respite RAC) (reference)	4	1.00		. .	13,498	54.9	
	Moving from hospital		1.19	***	(1.13 – 1.24)	9,591	41.3	
State/territory of RAC admission	New South Wales (reference)	9	1.00		. .	8,087	48.0	
	Victoria		0.93	**	(0.89 – 0.97)	6,110	50.9	
	Queensland		0.97		(0.92 – 1.02)	3,967	50.2	
	Western Australia		0.95		(0.88 – 1.02)	1,958	51.1	
	South Australia		0.99		(0.93 – 1.06)	2,187	46.7	
	Tasmania		0.92		(0.81 – 1.03)	557	46.3	
	Australian Capital Territory		0.91		(0.73 – 1.11)	193	52.8	
	Northern Territory		1.95	**	(1.23 – 3.08)	30	33.3	
RCS Category	RCS 1 (reference)	1	1.00		. .	4,301	30.3	
	RCS 2		0.78	***	(0.75 – 0.82)	6,681	36.4	
	RCS 3		0.59		(0.55 – 0.62)	3,921	47.3	
	RCS 4		0.44	***	(0.39 – 0.49)	982	60.1	
	RCS 5		0.34	***	(0.31 – 0.37)	2,048	68.8	
	RCS 6		0.26	***	(0.23 – 0.28)	2,065	74.3	
	RCS 7		0.22	***	(0.20 – 0.24)	2,593	76.4	
	RCS 8		0.15	***	(0.11 – 0.20)	230	83.5	
	RCS Missing–Low ACAT approval		1.45	**	(1.11 – 1.88)	113	48.7	
	RCS Missing–High ACAT approval		9.58	***	(8.00 – 11.47)	155	15.5	
First time in RAC	First time in RAC (reference)	8	1.00		. .	12,704	51.9	
	Most recently in RAC permanent		0.93	**	(0.88 – 0.97)	7,120	41.2	
	Most recently in RAC respite		0.92	**	(0.86 – 0.97)	3,265	56.9	
EP group	Australia/EP1 (reference)	5	1.00		. .	19,911	48.6	
	EP group2 		0.91	*	(0.84 – 0.99)	1,166	53.6	
	EP group3		0.84	***	(0.78 – 0.90)	1,847	53.5	
	EP group4		0.64	*	(0.43 – 0.95)	61	60.7	
	EP group unknown		1.08		(0.83 – 1.39)	104	43.3	
Region of RAC facility	Major cities (reference)	7	1.00		. .	16,255	49.8	
	Inner regional		1.08	**	(1.03 – 1.13)	4,954	47.6	
	Outer regional		1.13	***	(1.05 – 1.21)	1,743	48.4	
	Remote		0.99		(0.74 – 1.33)	108	55.6	
	Very remote		0.54		(0.27 – 1.09)	29	72.4	
Location of ACAT assessment	ACAT in hospital (reference)	6	1.00		. .	11,721	43.8	
	ACAT at home		0.90	***	(0.85 – 0.94)	6,696	61.2	
	ACAT in RAC		1.02		(0.97 – 1.09)	3,288	42.2	
	ACAT Other/Missing		0.84	***	(0.77 – 0.91)	1,384	55.3	
N	. .	. .	. .		. .	23,089	49.3	
*	Statistically significantly different from reference group at 5% level.
**        Statistically significantly different from reference group at 1% level.
***	Statistically significantly different from reference group at 0.1% level.
. .    	Not applicable to the model.
(a)	To achieve an overall Type I error rate of 5%, the significance level for each of the tests on the 10 variables included in the model building process was set to 0.5% using a Bonferroni adjustment. Marital status and several interactions (for example, age by sex) were tested for inclusion in the final model but were not statistically significant at the 0.5% level.
Table F.2:	Survival analysis results Model D: people entering permanent RAC from hospital, 
1 July–31 December 2001
Variable(a)	Level	Order of entry into model	Hazard ratio (95% confidence interval)	Number in group	Cens-ored ob’s	
							N	%	
	Female (reference)	 	1.00		. .			5,972	45.2	
Sex	Male	1	1.38	***	(1.31	–	1.46)	3,619	34.9	
Age	Increments of 1 year	5	1.03	***	(1.02	–	1.03)	9,591	41.3	
State/territory of RAC admission	. .	. .	. .		. .			9,591	41.3	
Region of RAC facility	. .	. .	. .		. .			9,591	41.3	
RCS Category	RCS 1 (reference)	2	1.00		. .		 	2,157	28.0	
	RCS 2	 	0.73	***	(0.68	–	0.78)	3,410	34.5	
	RCS 3	 	0.55	***	(0.51	–	0.60)	1,846	43.6	
	RCS 4	 	0.38	***	(0.33	–	0.45)	393	57.5	
	RCS 5	 	0.33	***	(0.29	–	0.38)	622	64.8	
	RCS 6	 	0.26	***	(0.22	–	0.31)	518	68.3	
	RCS 7	 	0.19		(0.16	–	0.23)	472	73.9	
	RCS 8	 	0.12	***	(0.05	–	0.33)	21	81.0	
	RCS Missing–Low ACAT approval	 	1.65	*	(1.08	–	2.52)	35	37.1	
	RCS Missing–High ACAT approval	 	5.74	***	(4.65	–	7.08)	117	13.7	
Care type in hospital	Acute (reference)	9	1.00		. .			4,789	38.3	
	Rehab	 	0.88		(0.76	–	1.02)	1,005	53.7	
	Palliative	 	1.70	***	(1.41	–	2.05)	181	8.8	
	GEM	 	0.93		(0.83	–	1.04)	866	47.0	
	Psychogeriatric	 	1.22		(0.90	–	1.63)	101	51.5	
	Maintenance	 	1.01		(0.91	–	1.11)	2,107	42.3	
	Other/Unknown	 	1.03		(0.89	–	1.19)	542	40.8	
Length of hospital episode	Less than one week (reference)	10	1.00		. .			951	41.4	
	[1,4) weeks	 	1.03		(0.94	–	1.13)	4,401	39.9	
	[4,8) weeks	 	1.00		(0.91	–	1.10)	2,628	40.9	
	[8,12) weeks	 	0.82	***	(0.72	–	0.93)	857	45.6	
	12 weeks or more	 	0.78	***	(0.68	–	0.89)	754	45.9	
								(continued)	
Table F.2 (continued): Survival analysis results Model D: people entering permanent RAC from hospital, 1 July–31 December 2001
Variable(a)	Level	Order of entry into model	Hazard ratio (95% confidence interval)	Number in group	Cens-ored ob’s	
						N	%	
Principal diagnosis in hospital	Neoplasms (cancers and tumours) (reference)	3	1.00		. .		 	458	14.4	
	Diseases of the circulatory system (excluding stroke and other cerebrovascular disease, ischaemic heart disease and diseases of the arteries)	 	0.52	***	(0.44	–	0.62)	384	31.5	
	Diseases of the circulatory system: stroke 	 	0.33	***	(0.28	–	0.39)	634	40.4	
	Diseases of the circulatory system: cerebrovascular disease (excl stroke)	 	0.36	***	(0.23	–	0.54)	40	40.0	
	Diseases of the circulatory system: ischaemic heart disease	 	0.44	***	(0.34	–	0.57)	114	33.3	
	Diseases of the circulatory system: diseases of the arteries	 	0.33	***	(0.23	–	0.48)	52	38.5	
	Mental and behavioural disorders (excluding dementia and related disorders) 	 	0.24	***	(0.20	–	0.30)	309	58.9	
	Mental and behavioural disorders: dementia and related disorders	 	0.27	***	(0.23	–	0.32)	553	43.2	
	Injury, poisoning and other consequences of external causes (excluding injury caused by fall)	 	0.29	***	(0.22	–	0.39)	110	46.4	
	Injury, poisoning and other consequences of external causes: injury caused by fall	 	0.28	***	(0.24	–	0.33)	686	41.7	
	Diseases of the nervous system	 	0.25	***	(0.21	–	0.30)	529	45.6	
	Diseases of the respiratory system (excluding COPD and influenza and pneumonia)	 	0.46	***	(0.36	–	0.59)	126	34.1	
	Diseases of the respiratory system: COPD	 	0.69	***	(0.57	–	0.84)	213	23.0	
	Diseases of the respiratory system: Influenza and pneumonia	 	0.41	***	(0.33	–	0.50)	187	32.6	
	Diseases of the genitourinary system (excluding kidney failure)	 	0.30	***	(0.24	–	0.37)	200	40.5	
	Diseases of the genitourinary system: Kidney failure	 	0.66	*	(0.47	–	0.94)	45	20.0	
	Diseases of the musculoskeletal system and connective tissue 	 	0.31	***	(0.26	–	0.38)	275	44.0	
	Diseases of the digestive system (excluding cirrhosis and other diseases of the liver)	 	0.40	***	(0.32	–	0.50)	175	36.0	
	Diseases of the digestive system: cirrhosis and other diseases of the liver	 	0.69		(0.36	–	1.35)	15	40.0	
	Diseases of the skin and subcutaneous tissue	 	0.31	***	(0.24	–	0.40)	130	41.5	
	Infectious and parasitic diseases	 	0.36	***	(0.25	–	0.52)	47	29.8	
								(continued)	
Table F.2 (continued): Survival analysis results Model D: people entering permanent RAC from hospital, 1 July–31 December 2001
Variable(a)	Level	Order of entry into model	Hazard ratio (95% confidence interval)	Number in group	Cens-ored ob’s	
						N	%	
Principal diagnosis in hospital (cont.)	Diseases of the blood and blood-forming organs and immunological disorders	 	0.45	***	(0.30	–	0.68)	32	18.8	
	Endocrine, nutritional and metabolic diseases (excluding diabetes mellitus)	 	0.48	***	(0.36	–	0.64)	92	33.7	
	Endocrine, nutritional and metabolic diseases: diabetes mellitus	 	0.42	***	(0.32	–	0.55)	87	24.1	
	Factors influencing health status (excluding ‘Awaiting admission elsewhere’)	 	0.30	***	(0.25	–	0.35)	1,592	49.9	
	Factors influencing health status: awaiting admission elsewhere	 	0.29	***	(0.25	–	0.34)	1,986	43.7	
	Symptoms, signs and abnormal findings n.e.c.	 	0.32	***	(0.27	–	0.38)	492	43.3	
	Other (including diseases of the ear and eye)/unknown	 	0.30	***	(0.18	–	0.50)	28	46.4	
Additional diagnosis of neoplasms 	Present	4	2.29	***	(2.08	–	2.52)	616	20.9	
	Absent (reference)	 	1.00		. .		 	8,975	42.7	
Additional diagnosis of kidney	Present	 6	1.49	***	(1.36	–	1.630	758	27.2	
	Absent (reference)	 	1.00		. .		 	8,833	42.5	
Additional diagnosis of COPD	Present	 7	1.37	***	(1.25	–	1.51)	670	27.3	
	Absent (reference)	 	1.00		. .		 	8,921	42.4	
Additional diagnosis of diseases of nervous system	Present	 8	0.82	***	(0.77	–	0.88)	2,588	45.8	
	Absent (reference)	 	1.00		. .		 	7,003	39.7	
Additional diagnosis of the skin and subcutaneous tissue	Present	 11	1.15	***	(1.07	–	1.23)	1,460	36.1	
	Absent (reference)	 	1.00		. .		 	8,131	42.3	
Additional diagnosis of diseases of arteries	Present	 12	1.28	***	(1.12	–	1.45)	383	32.4	
	Absent (reference)	 	1.00		. .		 	9,208	41.7	
Total	. .							9,591	41.3	
*	Statistically significantly different from reference group at 5% level.
**        Statistically significantly different from reference group at 1% level.
***	Statistically significantly different from reference group at 0.1% level.
. .    	Not applicable to the model.
(a)	To achieve an overall Type I error rate of 5%, variables were included in the final model if they had a p-value less than 0.12%. This p-value was calculated using a Bonferroni adjustment for 42 multiple comparisons. Other model building information includes:
•	State/territory and region of RAC facility were included in the final model, despite having a significance level higher than 0.12%, in order to control for variations in the provision of RAC services. The results of individual states and territories or regions are not presented.
•	Variables indicating marital status, location of ACAT assessment, English proficiency group, first time in RAC, hospital sector, number of hospital diagnoses and presence of specific diseases as additional diagnoses were tested for inclusion in the final model but were not statistically significant at the 0.12% level. Several interactions (for example, age by sex) were tested but found to be not significant at the 0.12% level.

Appendix G: Suppression of small cells
Suppression of cell values based on a small number of cases can be required to: 
a)	maintain data confidentiality, and/or
b)	avoid publishing statistics of very low accuracy.
In the current context, suppression of small cells is primarily required because of the second reason. Identification of individuals from the tabular data is extremely unlikely due to the limited information presented in the tables, and the known incompleteness of the identification of people moving from hospital to residential aged care.
Different suppression strategies are required depending on the type of information being presented and the number of small cells in the table. These are discussed below.
G.1	Derived statistics within table cells
Some tables contain statistics that relate only to the particular subgroup defined by the table cell (for example, mean length of stay). In this situation it is not possible to derive the value of one cell from other cells in the table. Examples include percentile values (for example, 
tables 3.18 and 3.19), ranks (diagnosis rank in table A.38) and prevalence estimates (for example, tables 6.5 and 6.8). Consequently, suppression is achieved by simply not publishing the affected cell’s statistic.
For this publication, cells containing derived statistics based on fewer than 5 records are replaced by ‘n.p.’ Note that publication of a percentile value required at least 5 records above and below the percentile. The publication of a median, for example, therefore required at least 10 records, while the publication of a 90th percentile required at least 50 records.    
G.2	Small cells within totals or subtotals > 1,000
G.2.1	A single small cell within totals
In some cases only a single cell in a set showing the distribution across subgroups (as in row per cents or totals and column per cents or totals) is based on a small number of cases. In this situation it is possible to derive the value of one cell from other cells in the table (for example, Table 3.23), and so suppressing the single cell does not achieve the required result. In this case, either:
•	The small cell is combined with a larger cell if such combination is logical and does not lead to losing important information. This is done by collapsing two categories into one within the table.
•	The two smallest cells are suppressed. 
For this publication, where sensible, the first of the above approaches is taken (for example, for tabulations involving age group or region type such as tables 2.7 and A.17). If this is not possible, an upper limit for the percentages or numbers is presented (for example, in 
Table 3.23 for psychogeriatric care for people from outer regional areas moving to permanent RAC). For numbers, that for the smallest cell is published as ‘<5’, with that for the larger of the two smallest cells being rounded up to lose 1 significant figure and presented as an upper limit (for example, ‘14’ would be published as ‘<20’). For percentages, that for the smallest cell is presented as an upper limit and published as ‘<x%’, where x is the percentage if there were 5 records. The percentage for the larger of the two smallest cells is based on the adjusted rounded number and also presented as an upper limit, published as ‘<y%’. 
G.2.2	Several small cells within totals
When several cells in a set showing the distribution across subgroups (as in row per cents or totals and column per cents or totals) are based on a small number of cases, suppressing all the affected cells achieves both a) and b) above. In this case, published percentages for all the small cells are based on 5 records, and the resulting common percentage is presented as an upper limit (published as ‘<x%’). For numbers, these cells are all published as ‘<5’. Table 3.23 provides several examples of this scenario.
Note that in extreme cases, the majority of cells in a row or column in a table may be affected by small numbers so that suppression of these cells would lead to leaving very little useful information (see, for example, the ‘NT’ column in Table 5.1). As a consequence, the entire row or column is suppressed and replaced by ‘n.p.’. Row and/or column suppression in such tables is treated on a case-by-case basis.
G.3	Small cells within totals or subtotals ≤ 1,000
G.3.1	Percentages for small cells
When a subtotal or total is less than or equal to 1,000 and percentages are rounded to 1 decimal point, the exact size of all cells is able to be derived when column or row totals are also presented. The following suppression methods are used when a table contains at least one small cell based on totals (or subtotals) of less than 1,000 records:
•	Two small cells (<5 records) and at least one other non-zero cell — the two small cells are set to 5 and the corresponding percentages are presented as ‘<x%’, where x is the percentage if there were 5 records (for example, Table 3.23) (as above in Section G.2.2).
•	Two non-zero cells only, with one small cell — the small cell is set to 5 and presented as ‘<x%’, where x is the percentage if there were 5 records. The larger cell is rounded down by the same amount that the small cell is adjusted up to reach 5 and is presented as a lower limit ‘>y%’. This method is also used to prevent small cell size calculation by subtraction (for example, in Table 3.15, values for diseases of the ear and mastoid process are affected by values for congenital malformations).
•	Two non-zero cells with one small cell and at least one null cell contributing to a total or subtotal— the small cell and one of the null cells are adjusted to 5 and presented as ‘<x%’, where x is the percentage if there were 5 records. The larger cell remains unchanged. Even if the number of records across the two adjusted cells is equal to 1, the uncertainty of which cell contains the record is sufficient to achieve suppression (no examples in this publication).
When one small cell within a row or column with subtotals or totals of 1,000 records or less is adjusted, the value of the next smallest group within that total is also suppressed to prevent calculation of the small cell by subtraction. In these cases, the above rules regarding suppression are used to determine the particular approach (see Table 3.14 for an example).
G.3.2	Totals or subtotals based on less than 20 records
When a total or subtotal is less than 20 records and contains one or several small cells (<5), it may not be sensible to present adjusted percentages. If only two cells are non-zero and one of them is small, then a decision to suppress is based on whether there is a statistically significant difference between the two percentages. In the case of two non-zero cells only, the smaller percentage is tested for statistical significance against a percentage of 50% using the cumulative binomial distribution function. Table G.1 shows the maximum cell size allowed in the smaller of the two groups for the split to be statistically significant. For example, if a population of 15 is split into two groups, there would need to be no more than 3 in the smaller group for the split to be considered unlikely to have happened purely due to chance. For totals and subtotals of less than 20, cells of less than 5 can occur by chance even when there is a 50:50 chance of being in either category. Data for samples of between 20 and 50 are also given in Table G.1 to illustrate the cell sizes required for splits to be significantly different from 50:50 in such cases.
For totals and subtotals under 20, if the smaller proportion is statistically significantly different to 50% at the 5% level, the cells are adjusted and presented as ‘<x%’ and ‘>y%’ as described above (for example, see the Transfer into respite: remote and very remote group in Table 4.5). Otherwise, both cells are presented as ‘n.p.’. There is, however, an exception: if the total or subtotal is 10 or fewer, even an adjusted split cannot be published as this would imply that the smaller cell had a single contributor. The application of these rules is shown in the last two columns in Table G.1.  
Where more than two cells are non-zero and at least one cell is small (<5) (for example, 
Table 5.1), suppression is achieved on a case-by-case basis by rounding subtotal percentages and presenting small cell values as ‘n.p.’ as necessary, starting from the most aggregated level to decide whether a cell value is publishable.

Table G.1:	Identifying significant two-way splits when total is based on less than 50 records
	95% cut-off(a):
maximum observed number with characteristic in the smaller group 	Closest significant split (95% significance)
per cent : per cent	If one cell is small, then publish as:	
Population size			Smaller cell	Larger cell	
10	1	10.0	:	90.0	n.p.	n.p.	
11	2	18.2	:	81.8	<45.5	>54.5	
12	2	16.7	:	83.3	<41.7	>58.3	
13	3	23.1	:	76.9	<38.5	>61.5	
14	3	21.4	:	78.6	<35.7	>64.3	
15	3	20.0	:	80.0	<33.3	>66.7	
16	4	25.0	:	75.0	<31.3	>68.8	
17	4	23.5	:	76.5	<29.4	>70.6	
18	5	27.8	:	72.2	<27.8	>72.2	
19	5	26.3	:	73.7	<26.3	>73.7	
20	5	25.0	:	75.0	<25.0	>75.0	
25	7	28.0	:	72.0	<20.0	>80.0	
30	10	33.3	:	66.7	<16.7	>83.3	
35	12	34.3	:	65.7	<14.3	>85.7	
40	14	35.0	:	65.0	<12.5	 >87.5 	
45	16	35.6	:	64.4	<11.1	>88.9	
50	28	36.0	:	64.0	<10.0	>90.0	
(a) 	The 95% cut-off is the number of observed records within a particular population size at or below which the binomial cumulative distribution function is less than 5% when the population probability of having a characteristic is assumed to be 50%. That is, observed numbers at or below the cut-off level indicate that the observed proportion is statistically significantly less than 50%. Note that there will always be a statistically significant difference at the 95% level when small cells (<5) occur within a population size of 18 or more. 
References 
ABS (Australian Bureau of Statistics) 2001a. Australian demographic statistics. Canberra: ABS.
ABS 2001b. Australian Standard Geographical Classification (ASGC). Canberra: ABS.
ABS 2002. Census of Population and Housing: CDATA 2001 – Full GIS, Australia, 2001. Canberra: ABS.
Aged Care Assessment Program National Data Repository 2005. Minimum Data Set Report Annual Report 2003–2004. 13 June 2006. Canberra: DoHA. Viewed 2 November 2006, <http://www.health.gov.au/internet/wcms/publishing.nsf/Content/1C26A001FC5317CFCA256F1900101306/$File/2003-2004.pdf>.
AIHW (Australian Institute of Health and Welfare) 2003a. Australian hospital statistics 
2001–02. Cat no. HSE 25. Canberra: AIHW.
AIHW 2003b. Interface between hospital and residential aged care, feasibility study on linking hospital morbidity and residential aged care data. Cat no. AGE 31. Canberra: AIHW.
AIHW 2003c. Residential aged care in Australia 2001–02: a statistical overview. Cat no. AGE 29. Canberra: AIHW.
AIHW 2004. The impact of dementia on the health and aged care systems. Cat no. AGE 37. Canberra: AIHW.
AIHW 2005. Australia’s welfare 2005. Cat no. AUS 65. Canberra: AIHW.
AIHW 2006. Data linkage and protecting privacy: a protocol for linking between two or more data sets held within the Australian Institute of Health and Welfare. Canberra: AIHW. Viewed 28 July 2006, <http://www.aihw.gov.au/dataonline/aihw_privacy_protection_protocols_data_linkage.pdf>
AIHW 2007a. Australia’s welfare 2007. Cat no. AUS 93. Canberra: AIHW.
AIHW 2007b. Older Australia at a glance (4th edition). Cat no. AGE 52. Canberra: AIHW.
AIHW: Karmel R 2004. Linking hospital morbidity and residential aged care data: Examining matching due to chance. Cat no. AGE 40. Canberra: AIHW.
AIHW: Karmel R, Anderson P & Lloyd J 2007a. Movement from hospital to residential aged care: preliminary results. Cat no. CSI 4. Canberra: AIHW.
AIHW: Karmel R, Hales C & Lloyd J 2007b. Older Australians in hospital. Bulletin 53. Canberra: AIHW.
AIHW: Karmel R & Rosman D 2007. Comparing name-based and event-based strategies for data linkage: a study linking hospital and residential aged care data for Western Australia. Cat no. CSI 3. Canberra: AIHW.
Anderson DR, Sweeney DJ & Williams TA 1994. Introduction to statistics: concepts and applications. St. Paul: West Publishing Company.
DIMA (Department of Immigration and Multicultural Affairs) 2003. 2001 classification of countries into English Proficiency Groups. Canberra: DIMA.
DoHA (Department of Health and Ageing) 2005. Residential care manual. 22 September 2004. Canberra: DoHA. Viewed 28 November 2007, 
<http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-manuals-rcm-rcmindx1.htm>.
Hosmer DW & Lemeshow S 2000. Applied logistic regression (2nd edition). John Wiley & Sons Inc.
Karmel R & Gibson D 2007. Event-based record linkage in health and aged care services data: a methodological innovation. BMC Health Services Research 7:154.
Klein JP & Moeschberger ML 1997. Survival analysis: techniques for censored and truncated data. New York: Springer-Verlag.
NCCH (National Centre for Classification in Health) 2000. The international statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM) 2nd edition. Sydney: University of Sydney.

List of tables
Table 1.1: 	Hospital separations for people aged 65+, by state/territory, 2001–02	3
Table 1.2:	RAC events by event type for people aged 65+, by state/territory, 2001–02	5
Table 1.3:	Movement types for hospital separations and RAC entries, people aged 65+, 2001–02	8
Table 2.1:	Movement from hospital and into RAC for people aged 65+, by movement type and state/territory, 2001–02 (unadjusted)	11
Table 2.2:	Summary of movements from hospital into RAC for people aged 65+, by movement type, Australia, 2001–02	13
Table 2.3:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, Australia, 2001–02 (unadjusted hospital separations)	13
Table 2.4:	Hospital separations for people aged 65+, by movement type and remoteness of usual residence prior to admission into hospital, 2001–02 (unadjusted)	14
Table 2.5:	Summary of movements from hospital into RAC for people aged 65+, by movement type and remoteness of usual residence prior to admission into hospital, Australia, 2001–02	14
Table 2.6:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by remoteness of usual residence prior to admission into hospital, Australia, 2001–02 (unadjusted hospital separations)	15
Table 2.7:	Hospital separations for people aged 65+: remoteness of usual residence prior to admission into hospital, by remoteness of hospital and movement type, 2001–02 (unadjusted)	16
Table 3.1: 	Hospital separations for people aged 65+, by movement type and hospital sector, Australia, 2001–02 (unadjusted)	18
Table 3.2:	Summary of movements from hospital into RAC for people aged 65+, by movement type and hospital sector, Australia, 2001–02	19
Table 3.3:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by hospital sector, Australia, 2001–02 (unadjusted hospital separations)	19
Table 3.4:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Australia, 2001–02	21
Table 3.5:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Australia, 2001–02 (unadjusted hospital separations)	22
Table 3.6:	Hospital separations for people aged 65+, by movement type, age and sex, Australia, 2001–02 (unadjusted)	23
Table 3.7:	Hospital separations for people aged 65+: mean length of stay, by movement type, age and sex, Australia, 2001–02 (unadjusted)	26
Table 3.8:	Hospital separations for people aged 65+: median length of stay, by movement type, age and sex, Australia, 2001–02 (unadjusted)	27
Table 3.9:	Hospital separations for people aged 65+: 90th percentile of length of stay, by movement type, age and sex, Australia, 2001–02 (unadjusted)	28
Table 3.10:	Summary of movements from hospital into RAC for people aged 65+, by hospital care type, Australia, 2001–02	30
Table 3.11:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by hospital care type, Australia, 2001–02 (unadjusted hospital separations)	32
Table 3.12:	Hospital separations for people aged 65+, by hospital care type and movement type, Australia, 2001–02 (unadjusted)	32
Table 3.13:	Hospital separations for people aged 65+: mean, median and 90th percentile of length of stay, by hospital care type and movement type, Australia, 2001–02 (unadjusted)	33
Table 3.14:	Summary of movements from hospital into RAC for people aged 65+, by principal diagnosis, Australia, 2001–02 (in order of decreasing prevalence)	37
Table 3.15:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by principal diagnosis, Australia, 2001–02 (unadjusted, in order of decreasing prevalence)	38
Table 3.16:	Hospital separations for people aged 65+, by principal diagnosis and movement type, Australia, 2001–02 (column per cent) (unadjusted, in order of decreasing prevalence)	39
Table 3.17:	Hospital separations for people aged 65+: mean length of stay, by principal diagnosis and movement type, Australia, 2001–02 (days) (unadjusted, in order of decreasing prevalence)	40
Table 3.18:	Hospital separations for people aged 65+: median length of stay, by principal diagnosis and movement type, Australia, 2001–02 (days) (unadjusted, in order of decreasing prevalence)	41
Table 3.19:	Hospital separations for people aged 65+: 90th percentile of length of stay, by principal diagnosis and movement type, Australia, 2001–02 (days) (unadjusted, in order of decreasing prevalence)	42
Table 3.20:	Summary of movements from hospital into RAC for people aged 65+, by movement type and number of diagnoses, Australia, 2001–02	43
Table 3.21:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by movement type and number of diagnoses, Australia, 2001–02 (unadjusted hospital separations)	43
Table 3.22:	Hospital separations for people aged 65+, by movement type, age and number of diagnoses, Australia, 2001–02 (unadjusted)	44
Table 3.23:	Hospital separations for people aged 65+, by movement type, hospital care type and remoteness of person prior to admission into hospital, 2001–02 (unadjusted)	46
Table 3.24:	Hospital separations for people aged 65+: mean, median and 90th percentile of length of stay, by movement type and remoteness of person prior to admission into hospital, 2001–02 (unadjusted)	48
Table 4.1:	Origin of non-transfer admissions into RAC for people aged 65+, admission type by age, sex and location of ACAT assessment, Australia, 2001–02 (adjusted)	50
Table 4.2:	RAC admissions for people aged 65+, by movement type, age and sex, Australia, 2001–02 (unadjusted)	51
Table 4.3:	RAC entries for people aged 65+, by movement type, sex and location of most recent ACAT assessment prior to move, Australia, 2001–02 (unadjusted)	53
Table 4.4:	RAC entries for people aged 65+: care level on transition, by movement type, age and sex, Australia, 2001–02 (% high care) (unadjusted)	55
Table 4.5:	RAC entries for people aged 65+: remoteness of person prior to admission into RAC, by remoteness of RAC facility and movement type, 2001–02 (unadjusted)	57
Table 5.1:	People aged 65+ returning to the community following RAC admission from hospital, by admission type and state/territory of usual residence, 2001–02 (unadjusted)	69
Table 5.2:	People aged 65+ returning to the community following RAC admission from hospital, by admission type and region of RAC facility, 2001–02 (unadjusted)	70
Table 5.3:	People aged 65+ returning to the community following RAC admission from hospital, by age, sex and admission type, 2001–02 (unadjusted)	72
Table 5.4:	People aged 65+ returning to the community following RAC admission from hospital, by care level and admission type, 2001–02 (unadjusted)	73
Table 5.5:	Survival times for people entering RAC from hospital, by principal diagnosis (sorted by decreasing hazard ratio, derived using adjusted reference person)	82
Table 6.1:	Transitions from hospital into RAC for people aged 65+: hospital diagnosis of dementia compared with the RAC dementia index, 2001–02 (unadjusted)	84
Table 6.2:	Hospital separations for people aged 65+ with any diagnosis of dementia, by sex and movement type, 2001–02 (unadjusted)	88
Table 6.3:	Summary of movements from hospital into RAC for people aged 65+ with any diagnosis of dementia, by movement type, Australia, 2001–02 (unadjusted)	89
Table 6.4:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+ with any diagnosis of dementia, by movement type, Australia, 2001–02 (unadjusted hospital separations)	90
Table 6.5:	Hospital separations for people aged 65+ with any diagnosis of stroke, by sex and movement type, 2001–02 (unadjusted)	91
Table 6.6:	Summary of movements from hospital into RAC for people aged 65+ with any diagnosis of stroke, by movement type, Australia, 2001–02	92
Table 6.7:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+ with any diagnosis of stroke, by movement type, Australia, 2001–02 (unadjusted hospital separations)	93
Table 6.8:	Hospital separations for people aged 65+ with principal diagnosis of injury and external cause of fall, by sex and movement type, 2001–02 (unadjusted)	94
Table 6.9:	Summary of movements from hospital into RAC for people aged 65+ with principal diagnosis of injury and external cause of fall, by movement type, Australia, 2001–02	95
Table 6.10:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+ with any diagnosis of injury and external cause of fall, by movement type, Australia, 2001–02 (unadjusted hospital separations)	96
Table 6.11:	Hospital separations for people aged 65+, by any diagnosis of dementia, movement type and hospital care type, 2001–02 (unadjusted)	99
Table 6.12:	Hospital separations for people aged 65+, by any diagnosis of stroke, movement type and hospital care type, 2001–02 (unadjusted)	100
Table 6.13:	Hospital separations for people aged 65+, by principal diagnosis of injury caused by fall, movement type and hospital care type, 2001–02 (unadjusted)	101
Table 6.14:	People aged 65+ entering RAC from hospital, by hospital diagnosis, movement type and RCS care level, 2001–02 (unadjusted)	102
Table 6.15:	Hospital separations for people aged 65+: median length of stay in hospital, by any dementia diagnosis, age and movement type, 2001–02 (unadjusted)	104
Table 6.16:	Hospital separations for people aged 65+: median length of stay in hospital, by any stroke diagnosis, age and movement type, 2001–02 (unadjusted)	105
Table 6.17:	Hospital separations for people aged 65+: median length of stay in hospital, by principal diagnosis of injury caused by a fall, age and movement type, 2001–02 (unadjusted)	106
Table 6.18:	People aged 65+ returning to the community following RAC admission from hospital: any diagnosis of dementia, by admission type, 2001–02 (unadjusted)	108
Table 6.19:	People aged 65+ returning to the community following RAC admission from hospital: any diagnosis of stroke, by admission type, 2001–02 (unadjusted)	109
Table 6.20:	People aged 65+ returning to the community following RAC admission from hospital: principal diagnosis of injury external cause of fall, by admission type, 
2001–02 (unadjusted)	110
Table A.1: 	All hospital separations by hospital admission mode and care type, people aged 65+, 2001–02 (unadjusted)	113
Table A.2:	Hospital separations for people aged 65+, by movement type, age and sex, New South Wales, 2001–02 (unadjusted)	114
Table A.3:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, New South Wales, 2001–02 (unadjusted)	115
Table A.4:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, New South Wales, 2001–02 (unadjusted hospital separations)	116
Table A.5:	Hospital separations for people aged 65+, by movement type, age and sex, Victoria, 2001–02 (unadjusted)	117
Table A.6:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Victoria, 2001–02	118
Table A.7:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Victoria, 2001–02 (unadjusted hospital separations)	119
Table A.8:	Hospital separations for people aged 65+, by movement type, age and sex, Queensland, 2001–02 (unadjusted)	120
Table A.9:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Queensland, 2001–02	121
Table A.10:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Queensland, 2001–02 (unadjusted hospital separations)	122
Table A.11:	Hospital separations for people aged 65+, by movement type, age and sex, Western Australia, 2001–02 (unadjusted)	123
Table A.12:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Western Australia, 2001–02	124
Table A.13:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Western Australia, 2001–02 (unadjusted hospital separations)	125
Table A.14:	Hospital separations for people aged 65+, by movement type, age and sex, South Australia, 2001–02 (unadjusted)	126
Table A.15:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, South Australia, 2001–02	127
Table A.16:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, South Australia, 2001–02 (unadjusted hospital separations)	128
Table A.17:	Hospital separations for people aged 65+, by movement type, age and sex, Tasmania, 2001–02 (unadjusted)	129
Table A.18:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Tasmania, 2001–02	130
Table A.19:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Tasmania, 2001–02 (unadjusted hospital separations)	130
Table A.20:	Hospital separations for people aged 65+, by movement type, age and sex, Australian Capital Territory, 2001–02 (unadjusted)	131
Table A.21:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Australian Capital Territory, 2001–02	132
Table A.22:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Australian Capital Territory, 2001–02 (unadjusted hospital separations)	132
Table A.23:	Hospital separations for people aged 65+, by movement type, age and sex, Northern Territory, 2001–02 (unadjusted)	133
Table A.24:	Summary of movements from hospital into RAC for people aged 65+, by sex and age, Northern Territory, 2001–02	134
Table A.25:	Ratio of permanent to respite admissions from hospital into RAC for people aged 65+, by sex and age, Northern Territory, 2001–02	134
Table A.26:	Hospital separations for people aged 65+: mean length of stay, by movement type, sex and state/territory, 2001–02 (days) (unadjusted)	135
Table A.27:	Hospital separations for people aged 65+: median of length of stay, by movement type, sex and state/territory, 2001–02 (days) (unadjusted)	136
Table A.28:	Hospital separations for people aged 65+: 90th percentile of length of stay, by movement type, sex and state/territory, 2001–02 (days) (unadjusted)	137
Table A.29:	RAC entries for people aged 65 and over, by movement type, sex and age, New South Wales, 2001–02 (unadjusted)	138
Table A.30:	RAC entries for people aged 65 and over, by movement type, sex and age, Victoria, 2001–02 (unadjusted)	139
Table A.31:	RAC entries for people aged 65 and over, by movement type, sex and age, Queensland, 2001–02 (unadjusted)	140
Table A.32:	RAC entries for people aged 65+, by movement type, age and sex, Western Australia, 2001–02 (unadjusted)	141
Table A.33:	RAC entries for people aged 65+, by movement type, age and sex, South Australia, 2001–02 (unadjusted)	142
Table A.34:	RAC entries for people aged 65+, by movement type, age and sex, Tasmania, 2001–02 (unadjusted)	143
Table A.35:	RAC entries for people aged 65+, by movement type, age and sex, Australian Capital Territory, 2001–02 (unadjusted)	144
Table A.36:	RAC entries for people aged 65+, by movement type, age and sex, Northern Territory, 2001–02 (unadjusted)	145
Table A.37:	Hospital separations for people aged 65+, by movement type and hospital care type, by state/territory, 2001–02 (unadjusted)	146
Table A.38:	Hospital separations for people aged 65+, by principal diagnosis, movement type and state/territory, 2001–02 (unadjusted, by national rank)	149
Table A.39:	RAC entries for people aged 65+: per cent high care by movement type by care level on transition by state/territory, 2001–02 (unadjusted)	155
Table B.1:	Data set partitioning and event date match rules for event-based constrained match selection	159
Table B.2:	Blocking variables and matching description used in Websphere® passes for constrained event-based linkage strategy	160
Table B.3:	PPV and sensitivity of preferred event-based linkage strategy, using Western Australian name-based linkage as the reference standard, linkage comparative study for 2000–01	163
Table B.4:	Final adjustments for estimates of flow by RAC event type and hospital care type of link, from Western Australian linkage study for 2000–01	164
Table C.1:	Disease classifications used in regression modelling	172
Table D.1:	English proficiency group classification	173
Table E.1:	Logistic regression results: factors affecting admission into RAC, 2001–02 (Model A)	180
Table E.2:	Logistic regression results: factors affecting admission into permanent RAC, 2001–02 (Model B)	184
Table E.3:	Logistic regression results: parameter estimates for Model A and Model B	188
Table F.1:	Survival analysis results Model C: all people entering permanent RAC, 1 July–31 December 2001	195
Table F.2:	Survival analysis results Model D: people entering permanent RAC from hospital, 1 July–31 December 2001	196
Table G.1:	Identifying significant two-way splits when total is based on less than 50 records	202

List of figures
Figure 1.1:	Schematic outlining the approach to analysis of movements	9
Figure 2.1:	Movement into RAC from hospital by jurisdiction	11
Figure 3.1:	Age and sex profile by post-hospital destination	20
Figure 3.2:	Length of stay by post-hospital destination	25
Figure 3.3:	Movement into RAC from hospital by hospital care type	31
Figure 3.4:	Selected principal diagnoses by post-hospital destination	35
Figure 3.5:	Reported co-morbidity by post-hospital destination	36
Figure 4.1: Profile of admissions into RAC	49
Figure 4.2:	Age and sex profile of admissions into RAC	49
Figure 4.3:	Per cent of admissions to RAC for people with high-care needs, 2001–02	54
Figure 5.1:	Short-term use of RAC: example pathways	66
Figure 5.2:	Movement of people after admission to RAC from hospital, 2001–02	67
Figure 5.3:	Average survival function for people entering permanent RAC during  July–December 2001	76
Figure 5.4:	Survival functions for people entering permanent RAC during July–December 2001,  by RCS category, sex, age and source of admission, controlling for all other variables	78
Figure 5.5:	Average survival function for people entering permanent RAC from hospital during July–December 2001	79
Figure 5.6:	Survival functions for people entering permanent RAC from hospital during  July–December 2001, by sex, length of hospital episode, hospital care type and additional hospital diagnoses, controlling for all other variables	80
Figure 5.7:	Survival functions for people entering permanent RAC from hospital during  July–December 2001, by selected principal diagnoses, controlling for all other variables	81
Figure 6.1:	Prevalence of selected health conditions by post-hospital destination	85
Figure 6.2:	Movement into RAC from hospital	86
Figure 6.3:	Relative use of acute care for selected health conditions, by post-hospital destination	97
Figure 6.4:	Median length of stay for selected health conditions, by post-hospital destination	103

List of boxes
Box 1.1:	Key terms in the hospital data	2
Box 1.2:	Key terms in RAC	4
Box 2.1:	Technical note on interpretation of unadjusted numbers of transitions	10
Box 3.1:	Technical note on estimates of length of stay in hospital	24
Box 3.2:	Care types for admitted patients	29
Box 5.1:	Reference person for comparison for Model A (discharge to community or RAC admission)	61
Box 5.2:	Reference person for comparison for Model B (discharge to permanent or respite RAC admission)	64
Box 5.3:	Reference person for comparison for survival analysis Model C (all persons to permanent RAC)	76
Box 5.4:	Reference person for comparison for survival analysis Model D (persons to permanent RAC from hospital)	79
Box 6.1:	Definition of selected diseases using ICD-10-AM Ed. 2 codes	83