R Briggs1, R Coary1, R Collins2, T Coughlan2, D O'Neill2, S P Kennelly3. 1. From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and. 2. From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and Department of Medical Gerontology, Trinity College, Dublin, Ireland. 3. From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and Department of Medical Gerontology, Trinity College, Dublin, Ireland sean.kennelly@amnch.ie.
Abstract
BACKGROUND: People with dementia are among the most frequent service users in the acute hospital. Despite this, the acute hospital is not organized in a manner that best addresses their needs. METHODS: We examined acute dementia care over a 3-year period from 2010 to 2012 in a 600-bed university hospital, to clarify the service activity and costs attributable to acute dementia care. RESULTS: Nine hundred and twenty-nine patients with dementia were admitted during the study period, accounting for 1433/69 718 (2%) of all inpatient episodes, comprising 44 449/454 169 (10%) of total bed days. The average length of stay was 31.0 days in the dementia group and 14.1 days in those >65 years without dementia. The average hospital care cost was almost three times more (€13 832) per patient with dementia, compared with (€5404) non-dementia patients, accounting for 5% (almost €20 000 000) of the total hospital casemix budget for the period. DISCUSSION: Service activity attributable to dementia care in the acute hospital is considerable. Moreover, given the fact that a significant minority of cognitive impairment goes unrecognized after acute admissions, it is likely that this is under-representative of the full impact of dementia in acute care. Although the money currently being spent on acute dementia care is considerable, it is being used to provide a service that does not meet its user needs adequately. It is clear that acute hospitals need to provide a more 'dementia friendly' service for acutely unwell older persons.
BACKGROUND:People with dementia are among the most frequent service users in the acute hospital. Despite this, the acute hospital is not organized in a manner that best addresses their needs. METHODS: We examined acute dementia care over a 3-year period from 2010 to 2012 in a 600-bed university hospital, to clarify the service activity and costs attributable to acute dementia care. RESULTS: Nine hundred and twenty-nine patients with dementia were admitted during the study period, accounting for 1433/69 718 (2%) of all inpatient episodes, comprising 44 449/454 169 (10%) of total bed days. The average length of stay was 31.0 days in the dementia group and 14.1 days in those >65 years without dementia. The average hospital care cost was almost three times more (€13 832) per patient with dementia, compared with (€5404) non-dementiapatients, accounting for 5% (almost €20 000 000) of the total hospital casemix budget for the period. DISCUSSION: Service activity attributable to dementia care in the acute hospital is considerable. Moreover, given the fact that a significant minority of cognitive impairment goes unrecognized after acute admissions, it is likely that this is under-representative of the full impact of dementia in acute care. Although the money currently being spent on acute dementia care is considerable, it is being used to provide a service that does not meet its user needs adequately. It is clear that acute hospitals need to provide a more 'dementia friendly' service for acutely unwell older persons.
Authors: Thomas A Jackson; John R F Gladman; Rowan H Harwood; Alasdair M J MacLullich; Elizabeth L Sampson; Bart Sheehan; Daniel H J Davis Journal: PLoS Med Date: 2017-03-14 Impact factor: 11.069
Authors: B M S McCausland; H P Patel; J Amin; D S Baldwin; K Loughran; V C Osman-Hicks Journal: Aging Clin Exp Res Date: 2018-09-26 Impact factor: 3.636