Online Program

334161
Mental Disorders' Impact on Older Patients' Long-Term Care Institutionalization upon Hospital Discharge:Evidence from 2007-2010 National Hospital Discharge Survey


Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Yu Kang, PhD, School of Health and Human Services, College of Public Affairs, University of Baltimore, Baltimore, MD
Nancy A. Miller, PhD, School of Public Policy, University of Maryland, Baltimore County, Baltimore, MD
Objective: Despite the policy efforts to reduce unwanted long-term care institutionalization, nursing home residents increasingly are being admitted from hospitals, with a significant share diagnosed with mental disorders. We examined factors associated with older mental health patients' discharge status. 

Methodology: We analyzed 79,310 older patients (age 65 and older) using the pooled data from the 2007 through 2010 National Hospital Discharge Survey. Logistic regression analyses were used to examine the risk factors for institutionalization. 

Findings: General mental disorders diagnosis increased the risks of institutionalization among the older patients (OR=1.65, 95%CI[1.54,1.76]). Patients with non-organic psychotic conditions were more likely to be institutionalized (OR=1.22, 95%CI[1.09, 1.37]). Being Black was associated with higher risks (OR=1.16, 95%CI[1.09,1.22]). Medicare coverage was associated with greater odds of institutionalization (OR=1.49, 95%CI[1.39, 1.60]). Admission through the ER or from nursing facilities substantially increased the odds of institutional use. Patients discharged with lower-limb fractures, HIV/AIDS, or ulcer experienced greater the odds to be institutionalized. Being discharged from larger hospitals (with >200 beds) decreased the risk for institutionalization; while being discharged from for-profit hospitals increased the risk among older patients. 

Implications: Older patients with mental disorders experienced significantly greater odds of institutionalization after adjusting for other factors. Being Black increased the risks of institution placement. Future research is necessary to explore the basis of this disparity.

Learning Areas:

Epidemiology
Public health or related public policy

Learning Objectives:
Analyze the factors associated with utilizing a Long-term care(LTC) institution upon hospital discharge, analyzing these factors in older populations. Discuss the policy implications of mental health patients' LTC needs. Discuss the policy implications of minority patients' LTC needs.

Keyword(s): Mental Health, Long-Term Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am mainly in charge of literature review, data analyses and writing of manuscript in this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.