[Impact of comorbid psychiatric disorders on the length of stay and the cost of medical treatment among geriatric patients treated on internal medicine wards]

(Idos, belgyógyászati fekvobetegek komorbid pszichiátriai állapotainak hatása a kórházi kezelés idotartamára és a kezeléssel kapcsolatos költségekre.)

Full Abstract

INTRODUCTION:
Coexistence of psychiatric comorbidity is very common in patients hospitalized with somatic problems. Several studies have shown that comorbid dementia increases the length of stay (LOS) in hospitals. The literature is more contradictory in the case of anxiety disorders, substance-related disorders, mood disorders and delirium.

AIMS:
Our aim was to explore the influence of psychiatric comorbidity on the average length of hospital stay and the related costs among geriatric patients treated in internal wards.

METHODS:
The examination was conducted on two departments of internal medicine for 3 months on all admitted patients above 65 years. Four psychometric tests were carried out in the first three days after hospitalization as a screen for psychiatric comorbidity.

RESULTS:
In the whole study group the incidence of a depression syndrome of various severity reached 56%. We have not identified any difference in LOS when the depressive and non-depressive groups were compared. 59% of the patients showed some degree of cognitive impairment. Mean LOS was 7.4 days longer among patient suffering in severe dementia than in the group showing no cognitive deficit.

CONCLUSION:
Our results have demonstrated that of the investigated psychiatric comorbid conditions, an increased LOS is connected only with dementia. The degree of the cognitive impairment shows a positive correlation with the length of stay and the cost of medical treatment. Given the high incidence rate of affective syndromes, it can be assumed that comorbid depression increases the chance of admission to an internal medicine ward with some somatic complaints. This can be attributed to a larval stage of depression manifesting as somatic symptoms.

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Author information

Author/s: Sebestyén, Gábor (G); Hamar, Mátyás (M); Bíró, László (L); Kovács, Gábor (G); Gazdag, Gábor (G);

Affiliation: Semmelweis Egyetem, Altalános Orvostudományi Kar, Budapest, Hungary.

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Psychiatria Hungarica : A Magyar Pszichiátriai Társaság tudományos folyóirata (Psychiatr Hung), published in Hungary. (Language: hun)

Reference: 2006-; vol 21 (issue 5) : pp 386-92

Dates: Created 2007/02/13; Completed 2007/05/16;

PMID: 17297201, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Chronic Disease - therapy
Cognition Disorders - epidemiology
Comorbidity
Depression - epidemiology
Female
Health Care Costs - statistics & numerical data
Hospital Costs

Hospital Departments - economics
Humans
Hungary - epidemiology
Internal Medicine
Length of Stay - statistics & numerical data
Male
Mental Disorders - epidemiology
Severity of Illness Index

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