Adams L Y, Koop P, Quan H, Norris C
MacEwan University, Edmonton, AB, Canada.
J Psychiatr Ment Health Nurs. 2015 Feb;22(1):39-46. doi: 10.1111/jpm.12169. Epub 2014 Nov 27.
Older adults with mental illness (MI) are a highly vulnerable population and need to be provided healthcare services in a timely and thorough way. Compared with older adults without MI, older adults with MI spend a great deal of time being hospitalized and hence costing millions of dollars because the care they need is often overlooked and/or not provided. While they end up spending too much time in hospital, in the emergency department and getting readmitted to hospital because of their MI, this could have been prevented or lessened if an adequate assessment and treatment regime was done by clinicians who were well informed on the topic of older adults' mental health. Older adults with MI are also more likely to leave hospital for long-term care settings, to die and to have more sickness compared with older adults who do not have MI. Further, they are also more likely to be admitted to hospital on an urgent, unplanned basis. How older adults with MI use acute hospitals is important for psychiatric nurses to know and understand, as they can help to provide the care needed so they do not have to be in hospital for long periods of time. Psychiatric nurses can share much support and information on making sure older adults with MI are accurately care for when needed. To explore and compare predictors of hospital length of stay (LOS), acute LOS (ALOS), emergency room (ER) wait times, rate of readmission (ROR) and costs of inpatient hospital care for older adults with and without mental illness (MI) diagnoses in the province of Newfoundland and Labrador (NL). This descriptive-comparative study used aggregate population level data of 12,283 people aged 65 years and older admitted to an acute care hospital in the province of NL. A total of 8.3% of hospitalized older adults had MI diagnoses. Older adults with MI diagnoses had a significantly longer LOS, ALOS, ROR, ER wait time and costs compared with older adults without MI diagnoses, after controlling for medical co-morbidities. Key variables such as patient demographics, admission indicators, discharge indicators and other medical co-morbidities had differential impacts on observed service use. While only a small percentage of hospitalized older adults had MI diagnoses, the use and cost of acute hospitalizations was significantly greater than that of older adults without MI diagnoses.
患有精神疾病（MI）的老年人是一个高度脆弱的群体，需要及时、全面地为他们提供医疗保健服务。与没有精神疾病的老年人相比，患有精神疾病的老年人住院时间很长，因此花费数百万美元，因为他们所需的护理常常被忽视和/或未得到提供。虽然他们最终在医院、急诊科花费了太多时间，并且由于精神疾病而再次入院，但如果临床医生对老年人心理健康问题有充分了解并进行充分的评估和治疗，这种情况本可以预防或减轻。与没有精神疾病的老年人相比，患有精神疾病的老年人也更有可能离开医院前往长期护理机构、死亡，并且患病更多。此外，他们也更有可能在紧急、无计划的情况下入院。了解患有精神疾病的老年人如何使用急症医院对精神科护士来说很重要，因为他们可以帮助提供所需的护理，使这些老年人不必长时间住院。精神科护士可以在确保患有精神疾病的老年人在需要时得到准确护理方面提供很多支持和信息。为了探索和比较纽芬兰和拉布拉多省（NL）有和没有精神疾病（MI）诊断的老年人的住院时间（LOS）、急性住院时间（ALOS）、急诊室（ER）等待时间、再入院率（ROR）和住院医疗费用的预测因素。这项描述性比较研究使用了该省一家急症护理医院收治的12283名65岁及以上老年人的总体人口水平数据。共有8.3%的住院老年人被诊断患有精神疾病。在控制了医疗合并症后，与没有精神疾病诊断的老年人相比，患有精神疾病诊断的老年人的住院时间、急性住院时间、再入院率、急诊室等待时间和费用明显更长。患者人口统计学、入院指标、出院指标和其他医疗合并症等关键变量对观察到的服务使用有不同影响。虽然只有一小部分住院老年人被诊断患有精神疾病，但急性住院的使用和费用明显高于没有精神疾病诊断的老年人。
