Title

Clinical characteristics of older adults admitted to an inpatient psychiatric unit: implications for resource allocation

Document Type

Article

Peer Reviewed

1

Publication Date

1-1-2003

Journal, Book or Conference Title

Journal of Mental Health & Aging

NLM Title Abbreviation

J Ment Health Aging

Abstract

This study assessed older adults with psychiatric conditions admitted to an inpatient psychiatric unit to determine whether patient characteristics at admission could distinguish persons most likely to achieve positive clinical outcomes from those not able to benefit meaningfully from acute hospitalization. The sample included 267 randomly chosen patients over 60 years of age discharged from an inpatient psychiatric service in a general hospital. The hospital was located in a metropolitan center of a rural state. Clinical and background information was gathered from chart review. Service use and cost data were obtained from hospital information systems. About 60% of older persons admitted to inpatient care presented with no safety risk and moderate or mild clinical symptoms. Length of stay did not vary along clinical need, degree of improvement, receipt of a behavioral intervention, or demographic variables. Most patients stayed longer than the Medicare reimbursed length of stay resulting in a negative operating margin. Findings suggest that not all persons admitted to inpatient care presented with clinical symptoms consistent with a need for this level of service intensity, implying an overreliance on inpatient hospitalization. Findings highlight the importance of guidelines as a critical factor to assist in level-of-care decision-making and the importance of defining appropriate efficacy measures for the geriatric patient.

Keywords

Community Mental Health Services -- Trends -- In Old Age, Health Resource Allocation, Patient Admission -- In Old Age, Psychiatric Patients -- In Old Age, Psychiatric Units, Aged, Chi Square Test, Descriptive Statistics, Female, Health Care Costs, Health Resource Utilization, Iowa, Length of Stay, Linear Regression, Male, Middle Age, Needs Assessment, P-Value, Record Review, Research Instruments, Retrospective Design, T-Tests, Human

Published Article/Book Citation

The definitive version was published in Journal of Mental Health & Aging, 9:4 (2003) pp.211-221.

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URL

http://ir.uiowa.edu/nursing_pubs/363