Trends in elderly psychiatric admissions to the Brazilian public health care system

Abstract

Objective: To evaluate trends in psychiatric bed occupancy by elderly inpatients in the Brazilian public health care system between 2000 and 2010 and to determine the leading psychiatric diagnosis for hospital admissions. Methods: Data from all 895,476 elderly psychiatric admissions recorded in the Brazilian Public Health Care Database (DATASUS) between January 2000 and February 2010 were analyzed. Polynomial regression models with estimated curve models were used to determine the trends. The number of inpatient days was calculated for the overall psychiatric admissions and according to specific diagnoses. Results: A moderate decreasing trend (p o 0.001) in the number of inpatient days was observed in all geriatric psychiatric admissions (R 2 = 0.768) and in admissions for organic mental disorders (R 2 = 0.823), disorders due to psychoactive substance use (R 2 = 0.767), schizophrenia (R 2 = 0.680), and other diagnoses (R 2 = 0.770), but not for mood disorders (R 2 = 0.472). Most admissions (60 to 65%) were due to schizophrenia. Conclusion: There was a decreasing trend in inpatient days for elderly psychiatric patients between 2000 and 2010. The highest bed occupancy was due to schizophrenia, schizotypal, and delusional disorders.

Schizophrenia hospitalization in the US 2005–2014

“…Of the studies conducted outside of the US to investigate schizophrenia-related hospitalization trends, few have utilized a nationally representative sample. [ 30 – 33 ] Subsequently, this study's primary aim is to examine the crude and standardized schizophrenia hospitalization rates in the US from 2005–2014. We hypothesized that there would be a statistically significant linear trend in hospitalization rates for schizophrenia from 2005–2014.…”

Psychiatric disorders as main discharge diagnosis by the Portuguese oldest old from 2000 to 2014: exploring national acute inpatient admissions

“…According to the most recent national report on mental health, only a small proportion of those with mental health problems have access to public specialized mental health services, and hospitalization continues to consume the majority of resources (DGS, 2016). Although not a leading cause for hospital admissions among older persons, psychiatric disorders are an important source of mental health expenditure (Chung, 2010;Ritter et al, 2016). Even though, the available evidence studying the prevalence of psychiatric disorders in the hospital context is scarce.…”

“…In a sample of patients aged ≥60 in a general hospital, Lyketsos et al (2000) found a prevalence of dementia among discharged patients of 3.9%, but with differences according to the age group (2.6% in the group aged 60-64 years, and 8.9% in the group aged 85 and older). Ritter et al (2016) evaluated trends in psychiatric bed occupancy by elderly inpatients in the Brazilian public healthcare system between 2000 and 2010, and found that schizophrenia, schizotypal, and delusional disorders were responsible for about 60% of the days spent in hospital by older inpatients.…”

Prevalence and trends of mental disorders requiring inpatient care in the city of Porto Alegre: a citywide study including all inpatient admissions due to mental disorders in the public system from 2013-2017

“…The most common diagnoses in the total sample were drug-related disorders, followed by mood, alcohol-related and psychotic disorders, but there were important differences across the age groups. There was a linear trend showing an increase in the number of admissions from 2013 to the midst of 2014, which again dropped in 2015 and subsequent years.To the best of the authors' knowledge, this is the first study to investigate the prevalence of people with mental disorders admitted to inpatient care units in a large Brazilian city, whereas previous efforts to estimate rates of inpatient utilization were limited to specific hospital settings,10,11 Brazilian states,[12][13][14] and age groups 15,16. new admissions and new records of the same hospitalization that continued (the unit of analysis is the record, not the individual) 13,15.…”