Admissions to long-term care following acute hospitalisations in older adults: Demographics and prior healthcare utilisation

Posted by on 30 April 2026

Summer student, Zachary Sit presents his report from his summer project. The full report can be downloaded here.

With the combination of New Zealand’s (NZ) ageing population and aging in place policies, many older people are living within our community with significant health and functional needs. Many older adults over the age of 85 utilise long-term care (LTC) facilities, and they have higher functional needs than in previous decades. The terminology around LTC varies internationally; in the NZ context, this encompasses four levels of care: rest home, private hospital, dementia unit and psychogeriatric specialist hospital.

Acute hospitalisation may be due to a new medical event that has occurred and changed an individual’s level of function acutely, such as a stroke or hip fracture, with an element of unpredictability, and may give rise to an unanticipated need to relocate to LTC. Alternatively, for some, transition to LTC may follow a decline in health and function with more frequent healthcare utilisation. Unanticipated transition into LTC can be a traumatic experience for older adults, while the sudden need for carers to search for a LTC facility can exacerbate an already stressful period of crisis. Additionally, it is recognised that discharge planning frequently contributes to prolonged hospital admissions. This is not only associated with increased risk of iatrogenic complications and functional decline in older adults, but also potentially impacts overall hospital flow and capacity, contributing to high costs. Taken together, an unplanned transition to LTC after an acute hospitalisation is less favourable compared to a planned transition from the community.

We aimed to

a) perform a descriptive analysis of the social and health demographics of older adults who previously resided in the community and transferred to LTC following an acute hospitalisation,
b) describe features of their hospitalisation prior to discharge to LTC and
c) describe secondary healthcare utilisation in the prior year to hospitalisation/LTC admission.

To our knowledge, no such description exists in the international literature, let alone in the NZ context. This information has potential to inform future studies exploring ways to improve pathways to LTC for older people, and/or opportunities to reduce pressures on acute hospital services.

 The full report can be downloaded here.