Association between Depressive disorder and hospital outcomes of care for elderly hospitalized patients

IF 1 Q4 GERONTOLOGY
Dimitrios Zikos, Olabisi Afolayan-Oloye
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Abstract

Depressive disorder is the most prevalent mental health issue among the elderly. Researchers have studied associations between poor outcomes of health and depressive disorder. However, there is limited knowledge on the association of depressive disorder on hospital outcomes of care for patients admitted due to acute health problems. This study utilized a large dataset from the Centers for Medicare and Medicaid Services to examine associations between depressive disorder and (i) length of stay, (ii) hospital mortality, and (iii) hospital-acquired septicemia, for hospitalized Medicare patients 65 years and above. Bivariate analysis was firstly conducted between each one of the outcomes of interest and the depressive disorder variable, and then, to control for demographics, primary diagnosis, and comorbidities, multiple logistic regression was conducted for the binary outcomes (hospital mortality and hospital-acquired septicemia) and multiple linear regression for the continuous outcome, Length of Stay. After adjusting for patient gender, ethnicity, primary diagnosis, and comorbidities, the presence of depressive disorder in elderly Medicare patients was found to be associated with increased odds for hospital death (OR = 1.186, C. I = 1.030—1.365), and a shorter hospital length of stay (b = -.697, p < 0.001). Black race was found to be protective for death for patients with depressive disorder. Since depression has an effect on various behavioral aspects of patients, the increased risk for hospital death underlines the need for a holistic patient care approach for acute patients with depression, including psychologic support, effective patient-therapist communication, and patient empowerment.

老年住院患者抑郁障碍与医院护理结果的关系
抑郁症是老年人中最普遍的心理健康问题。研究人员研究了健康状况不佳与抑郁障碍之间的关系。然而,关于抑郁症与因急性健康问题入院患者的医院护理结果之间的关系,目前知之甚少。这项研究利用联邦医疗保险和医疗补助服务中心的一个大型数据集来检验65岁及以上住院的联邦医疗保险患者的抑郁障碍与(i)住院时间、(ii)住院死亡率和(iii)医院获得性败血症之间的关联。首先在每一个感兴趣的结果和抑郁障碍变量之间进行双变量分析,然后,为了控制人口统计学、初级诊断和合并症,对二元结果(医院死亡率和医院获得性败血症)进行多元逻辑回归,对连续结果(住院时间)进行多元线性回归。在对患者性别、种族、主要诊断和合并症进行调整后,发现老年医疗保险患者中抑郁障碍的存在与医院死亡几率的增加有关(OR = 1.186,C.I = 1.030-1.365),住院时间更短(b = -.697,p <; 0.001)。发现黑人对抑郁症患者的死亡具有保护作用。由于抑郁症对患者的各个行为方面都有影响,住院死亡风险的增加突显了对急性抑郁症患者采取全面的患者护理方法的必要性,包括心理支持、有效的患者-治疗师沟通和患者赋权。
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来源期刊
Ageing International
Ageing International GERONTOLOGY-
CiteScore
2.70
自引率
6.70%
发文量
39
期刊介绍: As a quarterly peer-reviewed journal that has existed for over three decades, Ageing International serves all professionals who deal with complex ageing issues. The journal is dedicated to improving the life of ageing populations worldwide through providing an intellectual forum for communicating common concerns, exchanging analyses and discoveries in scientific research, crystallizing significant issues, and offering recommendations in ageing-related service delivery and policy making. Besides encouraging the submission of high-quality research and review papers, Ageing International seeks to bring together researchers, policy analysts, and service program administrators who are committed to reducing the ''implementation gap'' between good science and effective service, between evidence-based protocol and culturally suitable programs, and between unique innovative solutions and generalizable policies. For significant issues that are common across countries, Ageing International will organize special forums for scholars and investigators from different disciplines to present their regional perspectives as well as to provide more comprehensive analysis. The editors strongly believe that such discourse has the potential to foster a wide range of coordinated efforts that will lead to improvements in the quality of life of older persons worldwide. Abstracted and Indexed in: ABI/INFORM, Academic OneFile, Academic Search, CSA/Proquest, Current Abstracts, EBSCO, Ergonomics Abstracts, Expanded Academic, Gale, Google Scholar, Health Reference Center Academic, OCLC, PsychINFO, PsyARTICLES, SCOPUS, Social Science Abstracts, and Summon by Serial Solutions.
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