title: [Impact of comorbid psychiatric disorders on the length of stay and the cost of medical treatment among geriatric patients treated on internal medicine wards].
abstract: BACKGROUND
  Coexistence of psychiatric comorbidity is very common in patients hospitalized with somatic problems. Several studies have shown that comorbid dementia increases the length of stay (LOS) in hospitals. The literature is more contradictory in the case of anxiety disorders, substance-related disorders, mood disorders and delirium.
  
  
  OBJECTIVE
  Our aim was to explore the influence of psychiatric comorbidity on the average length of hospital stay and the related costs among geriatric patients treated in internal wards.
  
  
  METHODS
  The examination was conducted on two departments of internal medicine for 3 months on all admitted patients above 65 years. Four psychometric tests were carried out in the first three days after hospitalization as a screen for psychiatric comorbidity.
  
  
  RESULTS
  In the whole study group the incidence of a depression syndrome of various severity reached 56%. We have not identified any difference in LOS when the depressive and non-depressive groups were compared. 59% of the patients showed some degree of cognitive impairment. Mean LOS was 7.4 days longer among patient suffering in severe dementia than in the group showing no cognitive deficit.
  
  
  CONCLUSIONS
  Our results have demonstrated that of the investigated psychiatric comorbid conditions, an increased LOS is connected only with dementia. The degree of the cognitive impairment shows a positive correlation with the length of stay and the cost of medical treatment. Given the high incidence rate of affective syndromes, it can be assumed that comorbid depression increases the chance of admission to an internal medicine ward with some somatic complaints. This can be attributed to a larval stage of depression manifesting as somatic symptoms.
authors.affiliation: Semmelweis Egyetem, Altalános Orvostudományi Kar, Budapest, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Sebestyén
authors.forename: Mátyás
authors.initials: M
authors.lastname: Hamar
authors.forename: László
authors.initials: L
authors.lastname: Bíró
authors.forename: Gábor
authors.initials: G
authors.lastname: Kovács
authors.forename: Gábor
authors.initials: G
authors.lastname: Gazdag
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006748:Hospital Departments / Q000191:economics*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007388:Internal Medicine; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D012720:Severity of Illness Index