New stats suggest that over a quarter of hospitalisations of older Australians could be caused by poor medication-related primary care before admission – costing the Australian health system $300 million a year.

Research published in the Medical Journal of Australia has found many hospitalisations could potentially be prevented by delivery of appropriate medication-related primary care.

Chronic diseases currently account for 70 per cent of total health care expenditure in Australia.

“Optimal management of chronic disease has significant potential to reduce health care expenditure, as well as improve health outcomes for individuals,” University of South Australia lead researcher Dr Caughey says.

Dr Caughey’s team used data from the Department of Veterans’ Affairs from 2007 to 2012, to assess the prevalence of suboptimal medication related processes of care before hospitalisation of 83,430 patients.

They found that the overall proportion of hospitalisations that were preceded by suboptimal medication-related processes of care was 25.2 per cent.

Dr Caughey says the study highlights conditions for which there are evidence-practice gaps in medication management in the older population.

“At least one in 10 hospitalisations for chronic heart failure, ischaemic stroke, asthma, gastrointestinal ulcer or bleeding, fracture, renal failure or nephropathy, hyperglycaemia or hypoglycaemia were preceded by suboptimal medication-related processes of care,” she says.

“For example, 19 per cent and 17 per cent of fracture hospitalisations were for older men and women respectively who had a history of osteoporosis, but who had not received medication for it.

“Similarly, one in 10 admissions for renal failure occurred in patients with a history of diabetes who had not received a renal function test in the year before admission and were not dispensed an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker.

“We have developed evidence-based medication-related indicators of suboptimal processes of care before hospitalisation that are specific to the Australian health care setting. These indicators provide a means for quality improvement in the management of chronic conditions.”