title: Sedative-hypnotic use by the elderly: effects on hospital length of stay and costs.
abstract: Sedative-hypnotic medications are often used to treat anxiety and sleep disorders, although they may not be used appropriately. Relationships between hospital length of stay (LOS), costs, and levels of sedative-hypnotic use were examined. Charts of 856 elderly patients were reviewed for sedative hypnotic use and categorized into three groups: those whose use exceeded Health Care Financing Administration (HCFA) guidelines, those who used sedative-hypnotic medications but did not exceed HCFA guidelines, and those who did not receive any sedative-hypnotic medications. Patients whose sedative-hypnotic use exceeded guidelines had longer LOS (21.5 exceeding guidelines vs. 12.3 within guidelines vs. 6.7 no use, p < or = .001) and higher costs ($29,245 exceeding guidelines vs. $15,219 within guidelines vs. $7,516 no use, p < = or .001.) Even after controlling for severity of illness and comorbid conditions, differences in LOS and costs persisted. This study indicates that sedative-hypnotic medications are frequently prescribed to elderly patients, often in doses exceeding proposed guidelines, and are associated with longer hospital stays and higher hospital costs.
authors.affiliation: Center for Research in Medical Education and Health Care, Jefferson Medical College, Philadelphia, PA 19107-5083, USA. elaine.yuen@mail.tju.edu
authors.forename: E J
authors.initials: EJ
authors.lastname: Yuen
authors.forename: M H
authors.initials: MH
authors.lastname: Zisselman
authors.forename: D Z
authors.initials: DZ
authors.lastname: Louis
authors.forename: B W
authors.initials: BW
authors.lastname: Rovner
mesh_terms: D000367:Age Factors; D000368:Aged; D014487:Centers for Medicare and Medicaid Services, U.S.; D017723:Drug Utilization Review; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007902:Length of Stay; D008297:Male; D015143:Philadelphia; D017410:Practice Guidelines as Topic; D014481:United States
chemical_list: D006993:Hypnotics and Sedatives