Camberlin Cécile, Mistiaen Patriek, Beguin Claire, Van de Voorde Carine, Van den Heede Koen
Belgian Health Care Knowledge Centre (KCE), Doorbuilding, Boulevard du Jardin Botanique 55, 1000, Brussels, Belgium.
Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.
Eur Geriatr Med. 2019 Aug;10(4):577-583. doi: 10.1007/s41999-019-00205-0. Epub 2019 May 22.
Considering the limited information available, the aim of the study was to examine the prevalence and characteristics of inpatients with dementia in Belgian general hospitals.
All admissions of inpatients aged at least 40 years with or without dementia were retrieved from the nationwide administrative hospital discharges database for the period 2010-2014.
Admissions of inpatients aged 40 years or more with dementia have increased to reach 83,017 out of 1,285,593 admissions (6.46%) in general hospitals in 2014, mostly admitted through the emergency department (79.7%) and for another reason than dementia (85.9%). These patients stayed longer [19.2 days, standard deviation (sd) = 23.6, median = 13] than the average length of stay of patients of the same age (7.9 days, sd = 14.1, median = 17). Considering patients aged 75 years or more falling into the 20 most common pathology groups (of patients with dementia), the group with dementia spent 5 days more than the group without dementia. Patients admitted from home spent more time in hospital when they were discharged to a residential care facility than when they returned home (27.2 days versus 15.8 days). The in-hospital mortality was high in the first days of admission.
The growing prevalence of patients with dementia in inpatient setting puts a high pressure on the hospital capacity planning and geriatric expertise. Moreover, as patients with dementia should be kept outside hospitals when possible for safety and quality matters, long-term organizational investments are required inside hospital and residential care settings as well as in community care.
鉴于现有信息有限,本研究旨在调查比利时综合医院中痴呆症住院患者的患病率及特征。
从2010 - 2014年全国医院行政出院数据库中检索所有年龄至少40岁、患有或未患痴呆症的住院患者的入院信息。
2014年,综合医院中年龄40岁及以上的痴呆症住院患者入院人数增加至1,285,593例中的83,017例(6.46%),大多通过急诊科入院(79.7%),且入院原因并非痴呆症(85.9%)。这些患者的住院时间[19.2天,标准差(sd)= 23.6,中位数 = 13]长于同年龄患者的平均住院时间(7.9天,sd = 14.1,中位数 = 17)。对于年龄75岁及以上且属于20个最常见病理组(痴呆症患者)的患者,痴呆症组比非痴呆症组多住院5天。从家中入院的患者出院后入住寄宿护理机构时在医院停留的时间比回家时更长(27.2天对15.8天)。入院头几天的院内死亡率较高。
住院环境中痴呆症患者患病率的不断上升给医院容量规划和老年医学专业知识带来了巨大压力。此外,出于安全和质量考虑,痴呆症患者应尽可能不住院,因此医院内部、寄宿护理机构以及社区护理都需要进行长期的组织投资。