Dementia in elderly persons in a general hospital

Objective: This study investigated the prevalence of dementia in a general hospital, reasons for which patients with dementia were admitted, and the r elationship between dementia and length of stay, cost, and in-hospital mort ality rate. Method: The study focused on data from the hospital database on 21,251 pati ents aged 60 and older who were discharged in 1996 and 1997. Patients were grouped as with or without a discharge diagnosis of dementia by ICD-9-CM cr iteria. The groups were compared on sociodemographic characteristics, princ ipal discharge diagnoses, lengths of stay, costs, and in-hospital mortality rates. Results: The prevalence of dementia among discharged patients was 3.9% (N=8 23); it was dependent on age (age 60-64, prevalence=2.6%; age 85 and older, prevalence=8.9%). The primary discharge diagnoses of the groups were diffe rent. The mean length of stay was 10.4 days for patients with dementia and 6.5 days for patients without dementia. Per capita hospital costs were $4,0 00 higher for patients with dementia. Differences in lengths of stay and pe r capita costs were statistically significant after adjusting for ape, race , and sex. Lengths of stay and hospital costs for patients with dementia we re significantly higher for eight primary discharge diagnoses after adjusti ng far age, race, and sex. Conclusions: Dementia is present in a significant proportion of patients ad mitted to general inpatient units. Patients with dementia are admitted for different reasons than patients without dementia and appear to have longer stays, which are associated with higher casts. Efforts to identify dementia early during hospitalization could improve patient care and reduce costs.