Predictors of Inpatient Utilization among Veterans with Dementia

Author:

Godwin Kyler M.123,Morgan Robert O.4,Walder Annette12,Bass David M.5,Judge Katherine S.6,Wilson Nancy12,Snow A. Lynn78,Kunik Mark E.129

Affiliation:

1. Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030, USA

2. Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA

3. Memorial Hermann Hospital, Houston, 6411 Fannin, TX 77030, USA

4. The University of Texas School of Public Health, 1200 Herman Pressler, Rm. E-343, Houston, TX 77030, USA

5. Margaret Blenkner Research Institute, Benjamin Rose Institute on Aging, 11890 Fairhill Road, Cleveland, OH 44120, USA

6. Cleveland State University, 2121 Euclid Avenue, Cleveland, OH 44115, USA

7. Center for Mental Health and Aging and Department of Psychology, The University of Alabama, P.O. Box 870315, Tuscaloosa, AL 35487, USA

8. Tuscaloosa VA Medical Center, 3701 Loop Road, Tuscaloosa, AL 35404, USA

9. VA South Central Mental Illness Research, Education and Clinical Center (A Virtual Center), USA

Abstract

Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at theP<0.15level were subsequently analyzed in a multivariate regression. This study of veterans with a diagnosis of dementia (n=296) and their caregivers found marital status to predict hospitalization in the multivariate logistic model (B=0.493,P=0.029) and personal-care dependency to predict hospitalization and readmission in the multivariate logistic model and the multivariate negative binomial model (B=1.048,P=0.007,B=0.040, andP=0.035, resp.). Persons with dementia with personal-care dependency and spousal caregivers have more inpatient admissions; appropriate care environments should receive special care to reduce hospitalization. This study was part of a larger clinical trial; this trial is registered with ClinicalTrials.govNCT00291161.

Funder

Department of Veterans Affairs, Health Services Research and Development

Publisher

Hindawi Limited

Subject

Geriatrics and Gerontology

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