Trends in Mental Health Admissions to Nursing Homes, 1999-2005
Trends in Mental Health Admissions to Nursing Homes, 1999-2005
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DOI：
10.1176/appi.ps.60.7.965
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发表时间：
2009-07-01
影响因子：
3.8
通讯作者：
Grabowski, David C.
中科院分区：
文献类型：
--
作者：
Fullerton, Catherine Anne;McGuire, Thomas G.;Grabowski, David C.
目的：该研究检查了1999-2005年首次入住疗养院的精神疾病、痴呆或两者兼而有之的个人的数据，以确定趋势和特征。研究方法：最小数据集用于估计1999年至2005年期间新入住疗养院的精神疾病（精神分裂症、双相情感障碍、抑郁症或焦虑症）、痴呆症或两者兼而有之的人数和百分比。从2005年的数据被用来比较人口统计学特征和共病条件的三组和接受的治疗。结果：因精神疾病入院的人数从1999年的168 721人增加到2005年的187 478人。2005年的数字比仅因痴呆症入院的人数（2005年为118 290人）高出50%以上。这一增长是由于抑郁症患者的入院人数增加，从2005年的128 566人增加到154 262人。患有抑郁症的人比患有痴呆症或既没有痴呆症也没有精神疾病的人有更高的共病率。他们接受抗抑郁治疗的比例也很高，接受返回社区所需技能培训的比例也很高。结论：目前的趋势表明，精神疾病，特别是抑郁症的疗养院入院比例已经超过了痴呆症的比例。这些变化可能与人们对抑郁症的认识增加、老年痴呆症患者养老院的替代方案的可用性以及养老院在急性期后康复居民护理方面的专业化程度提高有关。鉴于这些趋势，至关重要的是要确保疗养院有足够的资源来治疗患有精神疾病的居民，以促进社区重新融合。（精神病学服务60：965-971，2009）
Objective: The study examined 1999-2005 data on first-time nursing home admissions of individuals with mental illness, dementia, or both to identify trends and characteristics. Methods: The Minimum Data Set was used to estimate the number and percentage of persons newly admitted to nursing homes who had mental illness (schizophrenia, bipolar disorder, depression, or an anxiety disorder), dementia, or both from 1999 to 2005. Data from 2005 were used to compare demographic characteristics and comorbid conditions of the three groups and treatments received. Results: The number of individuals admitted with mental illness increased from 168,721 in 1999 to 187,478 in 2005. The 2005 number is more than 50% higher than the number admitted with dementia only (118,290 in 2005). The increase was driven by growth in admissions of persons with depression-from 128,566 to 154,262 in 2005. Persons admitted with depression had higher rates of comorbid conditions than those admitted with dementia or with neither dementia nor mental illness. They also had high rates of antidepressant treatment and high rates of receipt of training in skills required to return to the community. Conclusions: Current trends show that the proportion of nursing home admissions with mental illness, in particular depression, has overtaken the proportion with dementia. These changes may be related to increased recognition of depression, availability of alternatives to nursing homes for persons with dementia, and increased specialization among nursing homes in the care of postacute, rehabilitation residents. In light of these trends, it is critical to ensure that nursing homes have resources to adequately treat residents with mental illness to facilitate community reintegration. (Psychiatric Services 60:965-971, 2009)