Predicting and improving hospital outcomes for older adults.
Predicting and improving hospital outcomes for older adults.
复制标题
预测和改善老年人的医院结果。
DOI：
10.1017/s1041610220003580
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发表时间：
2021-03
影响因子：
7
通讯作者：
Lee EE
中科院分区：
文献类型：
--
作者：
Adamowicz DH;Lee EE
Though older adults comprise less than 13% of the US population, they are disproportionately likely to be hospitalized (> 40% of hospitalizations) and incur nearly half of all the hospital costs (Healthcare Cost and Utilization Project Facts and Figures, 2008; US Census Bureau, 2008; US Centers for Disease Control and Prevention, 2010). Notably, a recent study of older adults in Italy determined that individuals who were characterized as pre-frail based on the Functional Geriatric Evaluation (FGE) scale accounted for around 30% of the study participants, yet generated close to half of the cumulative hospital costs (Liotta et al., 2019). Frailty on this scale has a multidimensional definition encompassing not only physical condition as traditionally emphasized (Fried et al., 2001), but also mental health, functional status, as well as socioeconomic resources (community support, housing, social relationships, and financial situation). Therefore, identifying and promoting factors to mitigate the decline toward frailty would undoubtedly have a positive impact on healthcare costs and quality of life in older adults. A recent review of the literature confirmed that medical and psychiatric comorbidity was linked to longer hospital stays, higher medical costs, and more readmissions in all adults (Jansen et al., 2018). Depression, in particular, increased the length of stay by 4–5days. In older adults, dementia is a prominent risk factor for delirium, which is associated with worse clinical and functional outcomes (Gual et al., 2018). In light of these findings, few studies have examined in systematic fashion how premorbid functioning in geriatric patients and other indices of frailty including neuropsychiatric symptoms affected hospitalization and patient outcomes.In their naturalistic study, Haupt et al.(2020) perform a retrospective analysis of the outcomes for all inpatients admitted to the geriatrics department of a hospital in Germany during a 6-month period (for a total of 280 patients). One-third of the patients assessed were admitted secondary to neuropsychiatric disorders, and 20% of all patients had both physical and mental illness. Patients with mental illness were categorized as having depression, dementia, or delirium. Overall, mentally ill patients had a greater number of comorbidities than those without mental illness, and that number was associated with depression severity, but not with general
