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Associations of medical comorbidity, psychosis, pain, and capacity with psychiatric hospital length of stay in geriatric inpatients with and without dementia

Published online by Cambridge University Press:  21 October 2014

Zahinoor Ismail ,
Tamara Arenovich ,
Robert Granger ,
Charlotte Grieve ,
Peggie Willett ,
Scott Patten  and
Benoit H Mulsant
Zahinoor Ismail*
Affiliation:
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Tamara Arenovich
Affiliation:
Clinical Research Department, Centre for Addiction and Mental Health, Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Robert Granger
Affiliation:
Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
Charlotte Grieve
Affiliation:
Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Peggie Willett
Affiliation:
Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Scott Patten
Affiliation:
Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Benoit H Mulsant
Affiliation:
Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
*
Correspondence should be addressed to: Zahinoor Ismail, Clinical Associate Professor of Psychiatry and Neurology, Hotchkiss Brain Institute, University of Calgary1403–29 Street NW, Calgary, Alberta, T2N 2T9, Canada. Phone: +403-944-1110; Fax: +403-283-4794. Email: zahinoor@gmail.com.
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Abstract

Background:

Geriatric psychiatry hospital beds are a limited resource. Our aim was to determine predictors of hospital length of stay (LOS) for geriatric patients with dementia admitted to inpatient psychiatric beds.

Methods:

Admission and discharge data from a large urban mental health center, from 2005 to 2010 inclusive, were retrospectively analyzed. Using the resident assessment instrument - mental health (RAI-MH), an assessment that is used to collect demographic and clinical information within 72 hours of hospital admission, 169 geriatric patients with dementia were compared with 308 geriatric patients without dementia. Predictors of hospital LOS were determined using a series of general linear models.

Results:

A diagnosis of dementia did not predict a longer LOS in this geriatric psychiatry inpatient population. The presence of multiple medical co-morbidities had an inverse relationship to length of hospital LOS – a greater number of co-morbidities predicted a shorter hospital LOS in the group of geriatric patients who had dementia compared to the without dementia study group. The presence of incapacity and positive psychotic symptoms predicted longer hospital LOS, irrespective of admission group (patients with dementia compared with those without). Conversely, pain on admission predicted shorter hospital LOS.

Conclusions:

Specific clinical characteristics generally determined at the time of admission are predictive of hospital LOS in geriatric psychiatry inpatients. Addressing these factors early on during admission and in the community may result in shorter hospital LOS and more optimal use of resources.

Keywords

geriatric psychiatryhospital length of stayLOSinpatientpredictorsdementiamedical burden
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 2 , February 2015 , pp. 313 - 321
Copyright
Copyright © International Psychogeriatric Association 2014 

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