Characteristics of Older Adults Hospitalized in Acute Psychiatric Units in Ontario: A Population-Based Study

Seitz, Dallas; Vigod, Simone N.; Lin, Elizabeth; Gruneir, Andrea; Newman, Alice; Anderson, Geoff; Rapoport, Mark J.; Rochon, Paula A.; Blumberger, Daniel M.; Herrmann, Nathan

doi:10.1177/070674371205700906

Cited by 14 publications

(9 citation statements)

References 45 publications

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“…The RAI‐MH much more reliably ascertains bipolar disorder diagnosis than other administrative data methods (i.e. physician claims or acute care discharge records) (Martin et al, ; Seitz et al, ). The RAI‐MH did not have information on clinician‐ascertained mood episode polarity, but did indicate the presence/absence of psychotic, manic, and depressive symptoms, and included Depressive Severity Index (DSI) scores (Perlman et al, ), allowing estimation of the frequency of major depression.…”

Section: Discussionmentioning

confidence: 99%

“…The Ontario Mental Health Reporting System (OMHRS) is a provincially mandated, centralized database. OHMRS consists of Resident Assessment Instrument Mental Health (RAI‐MH) assessments which are conducted on all psychiatric inpatients and includes detailed information on psychiatric diagnosis, substance use, and assessment protocols for mania, psychosis (Ismail et al, ), depression (Perlman et al, ), and psychosocial variables (Information, ; Seitz et al, ). Prescription drug use data was obtained from the Ontario Drug Benefit database (ODB), which records all outpatient prescription drugs dispensed to all residents aged ≥65.…”

Section: Methodsmentioning

confidence: 99%

“…Patients without a valid health care card were excluded. We focused on patients discharged from hospital (as opposed to outpatients): given concerns with outpatient administrative diagnostic coding for psychiatric conditions (Rej et al, ), this was the most reliable way to ensure that our sample had bipolar disorder using the detailed RAI‐MH database (Seitz et al, ).…”

Section: Methodsmentioning

confidence: 99%

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Current psychotropic medication prescribing patterns in late‐life bipolar disorder

Rej

Herrmann

Shulman

et al. 2016

Int J Geriat Psychiatry

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In clinical practice, older adults hospitalized with bipolar disorder are often prescribed multiple psychotropic medications upon discharge. In many instances, practices did not reflect bipolar treatment guidelines and may be putting patients at risk for poor physical health and psychiatric outcomes. One such example is the very infrequent use of lithium monotherapy. Future research should examine whether health system-wide protocolized late-life bipolar treatment may optimize prescribing to improve effectiveness and safety. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Current psychotropic medication prescribing patterns in late‐life bipolar disorder

Rej

Herrmann

Shulman

et al. 2016

Int J Geriat Psychiatry

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“…Also, we examined several potential predictors, including predictors identified in adult studies, whereas two studies only examined factors associated with late‐life hospitalization (Mercer et al, ) or <5 factors (Heeren et al, ). A large study by Prince et al used administrative Medicare data, which may have made it difficult to assess psychiatric diagnoses as a predictor, because these may not completely correspond with mental health physician billing claims due to confidentiality purposes or financial incentives (Prince et al, ; Seitz et al, ). It is also worth highlighting that aside from one very large study ( n > 40,000), our sample was larger than or of similar scale compared with the two other previous studies ( n = 150 total and n = 77 re‐hospitalizations, respectively) (Mercer et al, ; Heeren et al, ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of psychiatric re‐hospitalization in older adults with severe mental illness

Sylvestre

Segal

et al. 2015

Int J Geriat Psychiatry

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The rate of psychiatric re-hospitalization is high in older adults admitted for severe mental illness. Clinicians should be aware of the especially high rates of re-hospitalization in geriatric psychiatric inpatients with bipolar disorder, previous psychiatric admissions, or those living in a supervised setting. Future research could investigate approaches to prevent psychiatric re-hospitalization in these vulnerable sub-populations.

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“…Older adults in Canada account for 40% of total acute hospital days (De Coster et al 2004) and 44% of Canada's annual healthcare spending [Canadian Institute for Health Information (CIHI) 2008c]. Furthermore, a growing body of research consistently shows that older adults with mental illness (MI) use more acute hospital services and incur significantly greater costs than do older adults without MI diagnoses [Carriere et al 2004, Lai 2004, Canadian Mental Health Association (CMHA) 2005, CIHI 2006, 2008a, Madi et al 2007, McCusker et al 2007, Seitz et al 2012.…”

Section: Introductionmentioning

confidence: 99%

A population‐based comparison of the use of acute healthcare services by older adults with and without mental illness diagnoses

Adams

Koop

Quan

et al. 2014

Psychiatric Ment Health Nurs

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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.

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Characteristics of Older Adults Hospitalized in Acute Psychiatric Units in Ontario: A Population-Based Study

Cited by 14 publications

References 45 publications

Current psychotropic medication prescribing patterns in late‐life bipolar disorder

Current psychotropic medication prescribing patterns in late‐life bipolar disorder

Predictors of psychiatric re‐hospitalization in older adults with severe mental illness

A population‐based comparison of the use of acute healthcare services by older adults with and without mental illness diagnoses

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