Abstract
Background
Taking predictors of hospitalization characteristics into consideration internationally would broaden our understanding of this population on a local basis.
Aims
We aimed to examine and compare socio-demographic profiles along with hospitalization characteristics including length of hospital stay (LOS), reasons for admission and diagnoses among older adult inpatients hospitalized in Ireland and Turkey, and to assess factors predicting these features.
Methods
The admission charts of 356 psychiatric inpatients over 65 years of age who were admitted to two different acute psychiatric hospitals (Sligo/Ireland and Istanbul/Turkey) were analysed by means of descriptive modalities and logistic regression.
Results
There were significant differences in several domains of socio-demographics, reasons of admission and diagnoses. LOS was significantly longer in Ireland. Living alone was the only significant predictor for longer LOS in both countries, whereas in addition to living alone, younger age was also a contributor for longer LOS in Turkey.
Discussion
Given that the only factor predicting LOS both in Turkey and Ireland was living alone, helping to identify more acceptable ways of providing social support for living arrangements constitutes an important service to shorten LOS in old age psychiatric population.
Conclusions
It is possible to infer that independent from the cultural diversities, living arrangement is a consistent entity to influence length of hospital stay in older adult population.
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References
World Health Organization (2016) Fact sheets: mental health and older adults. http://www.who.int/mediacentre/factsheets/fs381/en/. Accessed 2016
Eurostat (2012) Europe in figures: Eurostat yearbook 2012. Luxemburg: Publications Office of the European Union. http://ec.europa.eu/eurostat/documents/3217494/5760825/KS-CD-12-001-EN.PDF/032ab046-5604-42cfb0a5-7e63e1cda8bb. Accessed 2012
Heslop K, Wynaden D, Bramanis K et al (2012) Assessing falls risk in older adult mental health patients: a Western Australian review. Int J Ment Health Nurs 21:567–575. doi:10.1111/j.1447-0349.2012.00825.x
Adamis D, Treloar A, Martin FC et al (2006) Recovery and outcome of delirium in elderly medical inpatients. Arch Gerontol Geriatr 43:289–298. doi:10.1016/j.archger.2005.11.005
Manu P, Grudnikoff E, Khan S et al (2013) Medical outcome of patients with dementia in a free-standing psychiatric hospital. J Geriatr Psychiatry Neurol 26:29–33. doi:10.1177/0891988712473799
Kleinpell RM, Fletcher K, Jennings BM (2008) Reducing functional decline in hospitalized elderly. In: Hughes RG (ed) Patient safety and quality: an evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US), Rockville, pp 260–306
Covinsky KE, Palmer RM, Fortinsky RH et al (2003) Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc 51:451–458. doi:10.1046/j.1532-5415.2003.51152.x
Mathews SB, Arnold SE, Epperson CN (2014) Hospitalization and cognitive decline: can the nature of the relationship be deciphered? Am J Geriatr Psychiatry 22:465–480. doi:10.1016/j.jagp.2012.08.012
Colenda CC, Mickus MA, Marcus SC et al (2002) Comparison of adult and geriatric psychiatric practice patterns: findings from the American Psychiatric Association’s Practice Research Network. Am J Geriatr Psychiatry 10:609–617. doi:10.1097/00019442-200209000-00015
Tulloch AD, Fearon P, David AS (2011) Length of stay of general psychiatric inpatients in the United States: systematic review. Adm Policy Ment Health 38:155–168. doi:10.1007/s10488-010-0310-3
Hodgson RE, Lewis M, Boardman J (2000) The prediction of in-patient length of stay for acute psychiatric admissions. J Ment Health 9:145–153. doi:10.1080/09638230050009140
Jacobs R, Gutacker N, Mason A et al (2015) Determinants of hospital length of stay for people with serious mental illness in England and implications for payment systems: a regression analysis. BMC Health Serv Res 15:439. doi:10.1186/s12913-015-1107-6
Chung W, Oh SM, Suh T et al (2010) Determinants of length of stay for psychiatric inpatients: analysis of a national database covering the entire Korean elderly population. Health Policy 94:120–128. doi:10.1016/j.healthpol.2009.09.004
McNamara A, Normand C, Whelan B (2013) The Irish longitudinal study on ageing: patterns and determinants of health care utilisation in Ireland. http://tilda.tcd.ie/assets/pdf/Tilda%20Health%20Care%20Utilisation%20Report.pdf. Accessed 2013
Eurostat (2015) Statistics explained: population structure and ageing. http://ec.europa.eu/eurostat/statisticsexplained/index.php/Population_structure_and_ageing. Accessed 2015
Turkish Statistical Institute (2015) Press release: turkish statistics. http://www.turkstat.gov.tr/PreHaberBultenleri.do?id=18625. Accessed 2015
World Health Organization (2015) Global health observatory data repository: repository population data by country. http://apps.who.int/gho/data/view.main.POP2040ALL?lang=en. Accessed 2015
Palmer BW, Heaton RK, Gladsjo JA et al (2002) Heterogeneity in functional status among older outpatients with schizophrenia: employment history, living situation, and driving. Schizophr Res 55:205–215. doi:10.1016/S0920-9964(01)00218-3
Dickerson FB, Brown CH, Kreyenbuhl J et al (2004) Sexual and reproductive behaviors among persons with mental illness. Psychiatr Serv 55:1299–1301. doi:10.1176/appi.ps.55.11.1299
Tucker S, Brand C, Wilberforce M et al (2015) Identifying alternatives to old age psychiatry inpatient admission: an application of the balance of care approach to health and social care planning. BMC Health Serv Res 15:267. doi:10.1186/s12913-015-0913-1
Sharfstein SS (2009) Goals of inpatient treatment for psychiatric disorders. Annu Rev Med 60:393–403. doi:10.1146/annurev.med.60.042607.080257
Blank K, Hixon L, Gruman C et al (2005) Determinants of geropsychiatric inpatient length of stay. Psychiatr Q 76:195–212. doi:10.1007/s11089-005-2339-x
Aich TK, Dhungana M, Muthuswamy R (2012) Pattern of neuropsychiatric illnesses in older age group population: an inpatient study report from Nepal. Indian J Psychiatry 54:23–31. doi:10.4103/0019-5545.94641
Ryan DJ, O’Regan NA, Caoimh RÓ et al (2013) Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ Open 3:e001772. doi:10.1136/bmjopen-2012-001772
George J, Adamson J, Woodford H (2011) Joint geriatric and psychiatric wards: a review of the literature. Age Ageing 40:543–548. doi:10.1093/ageing/afr080
Cohen CI, Casimir GJ (1989) Factors associated with increased hospital stay by elderly psychiatric patients. Hosp Community Psychiatry 40:741–743. doi:10.1176/ps.40.7.741
Aisen PS, Giblin KE, Packer LS et al (1994) Determinants of length of stay in geropsychiatry. Am J Geriatr Psychiatry 2:165–168. doi:10.1097/00019442-199405000-00010
Draper B, Luscombe G (1998) Quantification of factors contributing to length of stay in an acute psychogeriatrics ward. Int J Geriatr Psychiatry 13:1–7. doi:10.1002/(SICI)1099-1166(199801)13:1<1::AID-GPS716>3.0.CO;2-V
Liu CM, Li CS, Liu CC et al (2012) Determinants of psychogeriatric inpatient length of stay and direct medical costs: a 6-year longitudinal study using a national database in Taiwan. Psychiatry Clin Neurosci 66:423–431. doi:10.1111/j.1440-1819.2012.02377.x
DiNapoli EA, Regier N, McPherron J et al (2015) Predictors in geriatric psychiatry hospital length of stay. Psychiatr Q 86:243–251. doi:10.1007/s11126-014-9327-1
Ismail Z, Arenovich T, Granger R et al (2015) Associations of medical comorbidity, psychosis, pain, and capacity with psychiatric hospital length of stay in geriatric inpatients with and without dementia. Int Psychogeriatr 27:313–321. doi:10.1017/S1041610214002002
Gopalakrishna G, Ithman M, Malwitz K (2015) Predictors of length of stay in a psychiatric hospital. Int J Psychiatry Clin Pract 19:238–244. doi:10.3109/13651501.2015.1062522
Ismail Z, Arenovich T, Grieve C et al (2012) Predicting hospital length of stay for geriatric patients with mood disorders. Can J Psychiatry 57:696–703
Kitamura T, Kitamura M, Hino S et al (2013) Predictors of time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia. Dement Geriatr Cogn Disord Extra 3:86–95. doi:10.1159/000350028
Parks ED, Josef N (1997) A retrospective study of determinants of length of stay in a geropsychiatric state hospital. Psychiatr Q 68:91–99. doi:10.1023/A:1025413320151
Zhang J, Harvey C, Andrew C (2011) Factors associated with length of stay and the risk of readmission in an acute psychiatric inpatient facility: a retrospective study. Aust N Z J Psychiatry 45:578–585. doi:10.3109/00048674.2011.585452
Vanderhorst RK, McLaren S (2005) Social relationships as predictors of depression and suicidal ideation in older adults. Aging Ment Health 9:517–525. doi:10.1080/13607860500193062
Corna LM, Cairney J, Streiner DL (2010) Suicide ideation in older adults: relationship to mental health problems and service use. Gerontologist 50:785–797. doi:10.1093/geront/gnq048
Babalola O, Gormez V, Alwan NA et al (2014) Length of hospitalisation for people with severe mental illness. Cochrane Database Syst Rev 23:CD000384. doi:10.1002/14651858.CD000384.pub3
Oiesvold T, Saarento O, Sytema S et al (2000) Predictors for readmission risk of new patients: the Nordic Comparative Study on Sectorized Psychiatry. Acta Psychiatr Scand 101:367–373. doi:10.1034/j.1600-0447.2000.101005367.x
Blais MA, Matthews J, Lipkis-Orlando R et al (2003) Predicting length of stay on an acute care medical psychiatric inpatient service. Adm Policy Ment Health 31:15–29. doi:10.1023/A:1026044106172
Pertile R, Donisi V, Grigoletti L et al (2011) DRGs and other patient-, service- and area-level factors influencing length of stay in acute psychiatric wards: the Veneto Region experience. Soc Psychiatry Psychiatr Epidemiol 46:651–660. doi:10.1007/s00127-010-0231-1
Piccinelli M, Bortolaso P, Bolla E et al (2016) Typologies of psychiatric admissions and length of inpatient stay in Italy. Int J Psychiatry Clin Pract 20:116–120. doi:10.3109/13651501.2016.1166514
Jiménez RE, Lam RM, Marot M et al (2004) Observed-predicted length of stay for an acute psychiatric department, as an indicator of inpatient care inefficiencies. Retrospective case-series study. BMC Health Serv Res 4:4. doi:10.1186/1472-6963-4-4
Lalitanatpong D (2005) The use of electroconvulsive therapy and the length of stay of psychiatric inpatient at King Chulalongkorn Memorial Hospital, Thai Red Cross Society. J Med Assoc Thail 88:142–148
Compton MT, Craw J, Rudisch BE (2006) Determinants of inpatient psychiatric length of stay in an urban county hospital. Psychiatr Q 77:173–188. doi:10.1007/s11126-006-9005-z
Douzenis A, Seretis D, Nika S et al (2012) Factors affecting hospital stay in psychiatric patients: the role of active comorbidity. BMC Health Serv Res 12:166. doi:10.1186/1472-6963-12-166
Ithman MH, Gopalakrishna G, Beck NC et al (2014) Predictors of length of stay in an acute psychiatric hospital. J Biosaf Health Educ 2:119. doi:10.4172/2332-0893.1000119
Connolly S, O’Shea E (2015) The impact of dementia on length of stay in acute hospitals in Ireland. Dementia 14:650–658. doi:10.1177/1471301213506922
Wood R, Wand AP, Hunt GE (2015) Relationship between timeliness of contact and length of stay in older and younger patients of a consultation-liaison psychiatry service. BJPsych Bull 39:128–133. doi:10.1192/pb.bp.114.047340
Rechel B, Grundy E, Robine JM et al (2013) Ageing in the European Union. Lancet 381:1312–1322. doi:10.1016/S0140-6736(12)62087-X
Afilalo M, Soucy N, Xue X et al (2015) Characteristics and needs of psychiatric patients with prolonged hospital stay. Can J Psychiatry 60:181–188. doi:10.1177/070674371506000405
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Carpar, E., McCarthy, G., Adamis, D. et al. Socio-demographic characteristics and factors associated with hospitalization in psychiatry of old age patients: an international comparison between Ireland and Turkey. Aging Clin Exp Res 30, 651–660 (2018). https://doi.org/10.1007/s40520-017-0813-9
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DOI: https://doi.org/10.1007/s40520-017-0813-9