The Elderly Admitted to a General Hospital Psychiatry Ward

Abstract

In this retrospective study of 489 consecutive elderly admissions to a general hospital psychiatry ward, the main aim was to describe the stressors precipitating admission, psychiatric and medical diagnoses, physical treatments used, length of hospitalisation, and clinical and social outcome. Depression was the predominant diagnosis, with length of stay being correlated with depression severity. The main stressor associated with admissions was a change in medical status of the patient. At least two medical diagnoses were present in 70% of admissions, with many new physical illnesses being diagnosed. Significant improvement was found in 81% of admissions at discharge. Two thirds of admissions were discharged into independent living arrangements. While these outcomes suggested effective interventions, management difficulties were noted with the mix of elderly and young patients. It is recommended that acute psychogeriatric wards be developed in the general hospital and be located near geriatric medical wards.

Determinants of Geropsychiatric Inpatient Length of Stay

“…Inconsistent correlations with length of stay have been noted for key demographic characteristics; (1,(20)(21)(22)(23) age, gender and marital status are found to be both good (9,(24)(25)(26)(27)(28)(29)(30)(31)(32) and poor (1,14,(20)(21)(22)27,33,34) predictors of LOS. Interestingly, psychiatric diagnosis without some measure of severity and the diagnostic related groups (DRGs) used for Medicare reimbursement are also unpersuasive as predictors of LOS with as many studies finding them related to LOS (2,(5)(6)(7)17,21,22,24) as not (3,(9)(10)(11)(12)18,(35)(36)(37)(38)(39).…”

“…Prior research has found increased LOS among geriatric psychiatric patients to be associated with falling while hospitalized (16)(17)(18)(19)(20)(21)40), inability to return to prior living arrangement (1,20,33), ECT (16,17), and greater severity of psychiatric illness (23,36,37,41,42). On the other hand, cognitive impairment (21,22) has not been found to influence LOS.…”

Determinants of length of stay for psychiatric inpatients: Analysis of a national database covering the entire Korean elderly population

“…Although this study is the first step to overview the current Korean geropsychiatric inpatient care system, it has several limitations to evaluate such a bundled effect on LOS. First, the national administrative claim databases analysed in this study reflect the entire population of Korea, but it does not include clinical and social information such as severity, onset and duration of illness, recurrence, past medical history, marital status, housing, social support, involuntary admission, and so forth [14,15,42,[66][67][68]. Additionally, only principal diagnoses, not comorbid illnesses, were analysed.…”

Pattern of neuropsychiatric illnesses in older age group population: An inpatient study report from Nepal

“…[12131518] We have already mentioned that inpatient-based geropsychiatric study reports are rare, even in world psychiatric literature. [19] Thus, it was a difficult task for us to compare and discuss our study findings with reference to the existing literature. Our discussion is based mostly in relation to the available hospital outpatient-based study reports as well as community-based prevalence reports on geropsychiatric population.…”

“…[20] In general, in the western countries, the prevalence for elderly inpatients is higher than that of elderly people in the community, with estimates of 14% for patients in emergency departments, 18% for medical inpatients, and 23-44% for psychiatric inpatients. [21] In an inpatient study reported from Australia, Draper[19] found that 23% of total hospital admissions were in the age group of 65 years or more.…”