Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-11T02:30:55.410Z Has data issue: false hasContentIssue false
  • English
  • Français

The Hospital Dementia Services Project: age differences in hospital stays for older people with and without dementia

Published online by Cambridge University Press:  09 September 2011

Brian Draper ,
Rosemary Karmel ,
Diane Gibson ,
Ann Peut  and
Phil Anderson
Brian Draper*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
Rosemary Karmel
Affiliation:
Data Linkage Unit, Australian Institute of Health and Welfare, Canberra, Australia
Diane Gibson
Affiliation:
Faculty of Health, University of Canberra, Canberra, Australia
Ann Peut
Affiliation:
Ageing and Aged Care Unit, Australian Institute of Health and Welfare, Canberra, Australia
Phil Anderson
Affiliation:
Australian Institute of Health and Welfare, Canbersra, Australia
*
Correspondence should be addressed to: Professor Brian Draper, Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, 2031, Australia. Phone: +61 2 9382 3753; Fax: +61 2 9382 3762. Email: b.draper@unsw.edu.au.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: People with dementia may have adverse outcomes following periods of acute hospitalization. This study aimed to explore the effects of age upon hospitalization outcomes for patients with dementia in comparison to patients without dementia.

Methods: Data extracted from the New South Wales Admitted Patient Care Database for people aged 50 years and over for the period July 2006 to June 2007 were linked to create person-based records relating to both single and multiple periods of hospitalization. This yielded nearly 409,000 multi-day periods of hospitalization relating to almost 253,000 persons. Using ICD-10-AM codes for dementia and other principal diagnoses, the relationship between age and hospitalization characteristics were examined for people with and without dementia.

Results: Dementia was age-related, with 25% of patients aged 85 years and over having dementia compared with 0.9% of patients aged 50–54 years. People with dementia were more likely to be admitted for fractured femurs, lower respiratory tract infections, urinary tract infections and head injuries than people without dementia. Mean length of stay for admissions for people with dementia was 16.4 days and 8.9 days for those without dementia. People with dementia were more likely than those without to be re-admitted within three months for another multi-day stay. Mortality rates and transfers to nursing home care were higher for people with dementia than for people without dementia. These outcomes were more pronounced in younger people with dementia.

Conclusion: Outcomes of hospitalization vary substantially for patients with dementia compared with patients without dementia and these differences are frequently most marked among patients aged under 65 years.

Keywords

dementiahospitalizationoutcomeslength of stayage effects
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 10 , December 2011 , pp. 1649 - 1658
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Access Economics (2009) Keeping Dementia Front of Mind: Incidence and Prevalence 2009–2050. Canberra: Alzheimer's Australia.Google Scholar
ACEMA (Aged Care Evaluation and Management Advisors) (2003). Examination of Length of Stay for Older Persons in the Acute and Sub-Acute Sector. Report for the AHMAC Working Group on the Care of Older Australians. Canberra: Department of Health.Google Scholar
Borbasi, S., Jones, J., Lockwood, C. and Emden, C. (2006). Health professionals’ perspectives of providing care to people with dementia in the acute setting: toward better practice. Geriatric Nursing, 27, 300–308.Google Scholar
Creditor, M. C. (1993). Hazards of hospitalization of the elderly. Annals of International Medicine, 118, 219–223.Google Scholar
Douzenis, A. et al. (2010). Cognitive decline and dementia in elderly medical inpatients remain underestimated and underdiagnosed in a recently established university general hospital in Greece. Archives of Gerontology and Geriatrics, 50, 147–150.Google Scholar
Foreman, P. and Gardner, I. (2005). Evaluation of Education and Training of Staff in Dementia Care and Management in Acute Settings. Report for the Department of Human Services. Melbourne: Department of Human Services, Victoria.Google Scholar
Harvey, R. J., Skelton-Robinson, M. and Rossor, M. N. (2003). The prevalence and causes of dementia in people under the age of 65 years. Journal of Neurology, Neurosurgery and Psychiatry, 74, 1206–1209.Google Scholar
Inouye, S. K., Schlesinger, M. J. and Lydon, T. J. (1999). Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. American Journal of Medicine, 106, 565–573.Google Scholar
Karmel, R., Lloyd, J. and Anderson, P. (2008). Movement from Hospital to Residential Aged Care. Canberra: AIHW.Google Scholar
King, B., Jones, C. and Brand, C. (2006). Relationship between dementia and length of stay of general medical patients admitted to acute care. Australasian Journal on Ageing, 25, 20–23.Google Scholar
Kurrle, S. E. (2006). Improving acute care services for older people. Medical Journal of Australia, 184, 427–428.Google Scholar
Natalwala, A., Potluri, R., Uppal, H. and Heun, R. (2008). Reasons for hospital admissions in dementia patients in Birmingham, UK, 2002–2007. Dementia and Geriatric Cognitive Disorders, 26, 499–505.Google Scholar
National Centre for Classification in Health (1998). The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM). Sydney: National Centre for Classification in Health, Faculty of Health Sciences, University of Sydney.Google Scholar
Nichol, B., Lonergan, J. and Mould, M. (2000). The Use of Hospitals by Older People: A Casemix Analysis. Occasional Papers, New Series no. 11. Canberra: Commonwealth Department of Health and Aged Care.Google Scholar
Peut, A., Hogan, R., Goss, J., Mann, N. and Levings, B. (2007). Dementia in Australia: National data analysis and development. Canberra: AIHW.Google Scholar
Saravay, S. M. et al. (2004). How do delirium and dementia increase length of stay of elderly general medical inpatients? Psychosomatics, 45, 235–242.CrossRefGoogle ScholarPubMed
Torian, L., Davidson, E., Fulop, G., Sell, L. and Fillit, H. (1992). The effect of dementia on acute care in a geriatric medical unit.International Psychogeriatrics, 4, 231–239.Google Scholar
Withall, A. and Draper, B. (2009). What is the burden of younger onset dementia in Australia? International Psychogeriatrics, 21 (Suppl. 2), S26.Google Scholar
Zekry, D. et al. (2009). Does dementia predict adverse hospitalization outcomes? A prospective study in aged inpatients. International Journal of Geriatric Psychiatry, 24, 283–291.Google Scholar
Zilkens, R. R., Spilsbury, K., Bruce, D. G. and Semmens, J. B. (2009). Clinical epidemiology and in-patient hospital use in the last year of life (1990–2005) of 29,884 Western Australians with dementia. Journal of Alzheimer's Disease, 17, 399–407.Google Scholar
Zuliani, G. et al. (2011) Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia. International Journal of Geriatric Psychiatry. Epublished ahead of print. doi: 10.1002/gps.2722.Google Scholar