The evolving role of the state hospital in the care and treatment of older adults: state trend, 1984 to 1993.
OBJECTIVE
To understand the current and potential role of state hospitals in serving geriatric patients, national trends in the use of state mental hospitals by adults age 65 and older were examined.


METHODS
State hospital use by older adults in the 50 states and the District of Columbia was compared for the years 1984 and 1993 using published data from the Center for Mental Health Services.


RESULTS
Nationally, the number of state hospital admissions and residents declined between 1984 and 1993, and the rate of decrease was greater for older adults than for younger adults. However, states varied considerably in the rate of decrease in the number of older adult state hospital residents and admissions and in the proportion of older adult patients diagnosed with an organic mental disorder. In ten states, the older-adult state hospital population increased.


CONCLUSIONS
Although the national trend is toward a declining role for state hospitals in treatment and care of older adults, in several states the hospitals fill an important function in providing custodial care and acute care for this population.
Research infrastructure support program, National Association of State Mental Health Program Directors Research Institute, Alexandria, Virginia 22314, USA.
J
J
Semke
W H
WH
Fisher
H H
HH
Goldman
A
A
Hirad
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003482:Custodial Care / Q000639:trends; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D005544:Forecasting; D006299:Health Services for the Aged / Q000639:trends*; D006778:Hospitals, Psychiatric / Q000639:trends*; D006783:Hospitals, State / Q000639:trends*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends; D011158:Population Growth; D014481:United States / Q000453:epidemiology; D014600:Utilization Review