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Predictors of prolonged hospital stay for the treatment of severe neuropsychiatric symptoms in patients with dementia: a cohort study in multiple hospitals

Published online by Cambridge University Press:  23 April 2013

Hiromichi Sugiyama ,
Hiroaki Kazui ,
Kazue Shigenobu ,
Yoshihiro Masaki ,
Naoki Hatta ,
Daisuke Yamamoto ,
Tamiki Wada ,
Keiko Nomura ,
Kenji Yoshiyama  and
Kaoru Tabushi
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Hiromichi Sugiyama*
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
Hiroaki Kazui
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
Kazue Shigenobu
Affiliation:
Department of Psychiatry, Asakayama General Hospital, Sakai-City, Osaka, Japan
Yoshihiro Masaki
Affiliation:
Department of Psychiatry, Higashikakogawa Hospital, Kakogawa-City, Hyogo, Japan
Naoki Hatta
Affiliation:
Department of Psychiatry, Tamenaga Onsen Hospital, Minoh-City, Osaka, Japan
Daisuke Yamamoto
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
Tamiki Wada
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
Keiko Nomura
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
Kenji Yoshiyama
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
Kaoru Tabushi
Affiliation:
Department of Psychiatry, Asakayama General Hospital, Sakai-City, Osaka, Japan
Masatoshi Takeda
Affiliation:
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
*
Correspondence should be addressed to: Dr Hiromichi Sugiyama, MD, PhD, Department of Psychiatry, Osaka University Graduate School of Medicine, D3 2–2 Yamadaoka, Suita, Osaka 565-0871, Japan. Phone: +81-6-6879-3051; Fax: +81-6-6879-3059. Email: sugiyama@psy.med.osaka-u.ac.jp.
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Abstract

Background: Long hospitalization is often needed to treat severe behavioral and psychological symptoms of dementia (BPSD), which places heavy demands on hospital resources. Consequently, patients with severe BPSD usually wait for a long time to be admitted. There is a need to identify factors related to long hospitalization to better manage resources of a psychiatric hospital.

Methods: We surveyed 150 consecutive patients hospitalized in the neuropsychiatric units of three hospitals for treatment of BPSD from 11 May 2009 to 30 November 2010. Only patients with reliable relatives were included in the study. We evaluated data of the patients (demographics, cognitive impairment, activities of daily living, causal disease for dementia, dementia severity, and the amount of pension), their primary caregivers (demographics and care burden), and their doctors’ years of experience in treating dementia. We followed up to 180 days and assessed the effect of these factors on the length of stay.

Results: Of the 150 patients, 104 were discharged within 180 days and 46 were hospitalized for more than 180 days. Average length of stay for patients was 110.4 ± 58.1 days. In both univariate and multivariate Cox proportional hazard analyses, length of stay was longer for patients with smaller pensions and patients whose doctors had fewer years of experience in treating dementia. Length of stay was not found to be associated with any of the other variables.

Conclusions: Patients with smaller pensions and whose doctors had less experience in treating dementia tended to require longer hospitalization.

Keywords

prolonged hospital staybehavioral and psychological symptoms of dementia (BPSD)hospital-based cohort studytreatmentCox proportional hazard analysis
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 8: Elder abuse an international perspective , August 2013 , pp. 1365 - 1373
Copyright
Copyright © International Psychogeriatric Association 2013 

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