Sedative-hypnotic use and increased hospital stay and costs in older people.
OBJECTIVE
To assess the relationship between sedative-hypnotic (S/H) utilization, severity of illness, length of stay, and hospital costs among older patients admitted to a tertiary care university hospital.


METHODS
Retrospective review of computerized hospital and pharmacy data bases.


METHODS
A total of 856 older consecutive medical and surgical admissions from November 1993 to March 1994.


METHODS
Sedative/hypnotic utilization in accord with the Health Care Financing Administration (HCFA) guidelines for S/H use in nursing homes. Jefferson Disease Staging to estimate severity of illness. Hospital records to obtain demographic characteristics, length of stay, and hospital costs.


RESULTS
Patients whose S/H use exceeded HCFA guide lines, compared with those within the guidelines and those receiving no drugs, had longer lengths of stay (21.5 days vs 12.3 days vs 6.7 days, P < .001), increased hospital costs ($29,245 vs $15,219 vs $7,516, P < .001). and greater severity of illness (245.8 vs 189.5 vs 148.5, P < .001). S/H use exceeding and within HCFA guidelines were associated with increased length of stay (both P < .0001) and hospital costs (both P < .0001).


CONCLUSIONS
Older hospitalized patients receiving S/H have greater severity of illness, longer lengths of stay, and higher hospital costs compared with other patients. S/H use, and, in particular, S/H use exceeding the HCFA guidelines, are associated with increased hospital stay and cost.
Department of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, PA, USA.
M H
MH
Zisselman
B W
BW
Rovner
E J
EJ
Yuen
D Z
DZ
Louis
D000368:Aged; D004305:Dose-Response Relationship, Drug; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics / Q000627:therapeutic use*; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D015143:Philadelphia; D017410:Practice Guidelines as Topic; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index
D006993:Hypnotics and Sedatives