Depressive symptoms as a predictor of 6-month outcomes and services utilization in elderly medical inpatients.

Details

Serval ID
serval:BIB_8E96781BE608
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Depressive symptoms as a predictor of 6-month outcomes and services utilization in elderly medical inpatients.
Journal
Archives of Internal Medicine
Author(s)
Büla C.J., Wietlisbach V., Burnand B., Yersin B.
ISSN
0003-9926 (Print)
ISSN-L
0003-9926
Publication state
Published
Issued date
11/2001
Peer-reviewed
Oui
Volume
161
Number
21
Pages
2609-2615
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Depressive symptoms have been associated with higher mortality in hospitalized elderly persons, but few data are available associating depressive symptoms with other outcomes.
OBJECTIVE: To determine the association between depressive symptoms and the risk of hospital readmission, nursing home admission, and death as well as inpatient services utilization during a 6-month follow-up period in a cohort of elderly medical inpatients.
METHODS: We enrolled 401 patients, 75 years and older, admitted to the internal medicine service of an academic hospital in Lausanne, Switzerland. Data on demographic, medical, physical, social, and mental status were collected on admission. Depressive symptoms were defined as a score of 6 or higher on the Geriatric Depression Scale short form. Follow-up data were gathered from the centralized billing system (hospital and nursing home admissions) and from proxies (in cases of death).
RESULTS: In bivariate analysis, depressive symptoms were associated with an increased risk of hospital readmission, nursing home placement, and death. After adjustment for demographic, socioeconomic, and functional status and comorbidity, depressive symptoms remained associated with an increased risk of hospital readmission (adjusted hazard ratio, 1.50; 95% confidence interval, 1.03-2.17; P =.03). In addition, depressive symptoms were associated with increased average costs of both acute and rehabilitation services, resulting in higher overall costs of inpatient services. ($175.70 vs $126.00; P<.001). This association remained after adjusting for differences in functional status, comorbidity, and living situation, although it was just short of statistical significance (P =.07).
CONCLUSIONS: Elderly medical inpatients with depressive symptoms were more likely than those without to be readmitted and had higher inpatient services utilization during the follow-up period, independent of functional and health status. These results emphasize the need for interventions directed at improving management of depressive symptoms, given the low recognition and treatment rates of this problem in elderly populations.
Keywords
Aged, Aged, 80 and over, Cohort Studies, Depression/psychology, Female, Follow-Up Studies, Humans, Inpatients/psychology, Length of Stay, Male, Nursing Homes, Outcome Assessment (Health Care), Patient Participation, Patient Readmission, Predictive Value of Tests, Risk Factors, Time Factors
Pubmed
Web of science
Open Access
Yes
Create date
24/01/2008 16:31
Last modification date
20/08/2019 14:52
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