The association of individual and facility characteristics with psychiatric hospitalization among nursing home residents.
OBJECTIVE
To examine resident and facility characteristics associated with psychiatric hospitalizations (PH) for Medicaid enrolled nursing home (NH) residents.


METHODS
Participants were all Medicaid enrolled NH residents (n = 32,604) from all Medicaid certified nursing homes in Florida (n = 584) with complete data. We used individual demographic and diagnostic characteristics, as well as facility characteristics, to explore risk of psychiatric hospitalization in this dataset.


RESULTS
Using generalized estimating equations, we found that younger age, male gender, poor physical health, serious mental illness, dementia, and drug use disorder were associated with risk of psychiatric hospitalization. Most notably, residents under 65 were more than three times more likely to undergo psychiatric hospitalization and dementia was associated with a three-fold increase in the risk of psychiatric hospitalization. Predictors of PH differed somewhat for younger and older residents. Among facility characteristics, greater facility size, low proportion of those paying via Medicare and high proportion of residents with serious mental illness were associated with increased risk of psychiatric hospitalization, whereas, low proportion of residents paying via Medicaid, high proportion of residents paying via Medicare, and low proportion of resident with serious mental illness were associated with reduced risk.


CONCLUSIONS
Both resident and facility characteristics impact risk for psychiatric hospitalization. Attention to identified predictors may reduce risk and improve outcomes for nursing home residents.
Becker
Marion
M
Department of Mental Health Law and Policy - MHC 2735, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL 33612, USA. becker@fmhi.usf.edu
Andel
Ross
R
Boaz
Timothy
T
Howell
Timothy
T
D000367:Age Factors; D000368:Aged; D003704:Dementia / Q000451:nursing / Q000523:psychology*; D005260:Female; D005431:Florida; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006707:Homes for the Aged / Q000592:standards / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D012737:Sex Factors; D014481:United States