Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure

Steven L. Sayers, Nancy Hanrahan, Ann Kutney, Sean Clarke, Brendali F. Reis, Barbara Riegel

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.

Original languageEnglish (US)
Pages (from-to)1585-1591
Number of pages7
JournalJournal of the American Geriatrics Society
Volume55
Issue number10
DOIs
StatePublished - Oct 1 2007

Fingerprint

Psychiatry
Comorbidity
Length of Stay
Hospitalization
Heart Failure
Costs and Cost Analysis
Inpatients
Diagnosis-Related Groups
Medicare
Cross-Sectional Studies
Economics

Keywords

  • Depression
  • Economic analysis
  • Heart failure
  • Hospitalization costs
  • Medicare
  • Psychiatric comorbidity
  • Race/ethnicity
  • Sex
  • Socioeconomic status

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure. / Sayers, Steven L.; Hanrahan, Nancy; Kutney, Ann; Clarke, Sean; Reis, Brendali F.; Riegel, Barbara.

In: Journal of the American Geriatrics Society, Vol. 55, No. 10, 01.10.2007, p. 1585-1591.

Research output: Contribution to journalArticle

Sayers, Steven L. ; Hanrahan, Nancy ; Kutney, Ann ; Clarke, Sean ; Reis, Brendali F. ; Riegel, Barbara. / Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure. In: Journal of the American Geriatrics Society. 2007 ; Vol. 55, No. 10. pp. 1585-1591.
@article{fed8bf0152324eb591ed2463bc4f7c7e,
title = "Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure",
abstract = "OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5{\%} national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8{\%} of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5{\%} of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.",
keywords = "Depression, Economic analysis, Heart failure, Hospitalization costs, Medicare, Psychiatric comorbidity, Race/ethnicity, Sex, Socioeconomic status",
author = "Sayers, {Steven L.} and Nancy Hanrahan and Ann Kutney and Sean Clarke and Reis, {Brendali F.} and Barbara Riegel",
year = "2007",
month = "10",
day = "1",
doi = "10.1111/j.1532-5415.2007.01368.x",
language = "English (US)",
volume = "55",
pages = "1585--1591",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure

AU - Sayers, Steven L.

AU - Hanrahan, Nancy

AU - Kutney, Ann

AU - Clarke, Sean

AU - Reis, Brendali F.

AU - Riegel, Barbara

PY - 2007/10/1

Y1 - 2007/10/1

N2 - OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.

AB - OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.

KW - Depression

KW - Economic analysis

KW - Heart failure

KW - Hospitalization costs

KW - Medicare

KW - Psychiatric comorbidity

KW - Race/ethnicity

KW - Sex

KW - Socioeconomic status

UR - http://www.scopus.com/inward/record.url?scp=34848854254&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34848854254&partnerID=8YFLogxK

U2 - 10.1111/j.1532-5415.2007.01368.x

DO - 10.1111/j.1532-5415.2007.01368.x

M3 - Article

C2 - 17714458

AN - SCOPUS:34848854254

VL - 55

SP - 1585

EP - 1591

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 10

ER -