title: Impact of psychotic disorders on discharge dispositions of adults 65 or older after a general medical inpatient stay.
abstract: OBJECTIVE
  This study examined the extent to which a psychotic disorder, as well as demographic and clinical characteristics, predicted the discharge disposition of adults aged 65 or older after a hospital stay for a general medical illness.
  
  
  METHODS
  Data from a nationally representative sample of hospital discharges among persons 65 years of age or older (N=2,334,130) were drawn from the 2007 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. A series of multivariate logistic regression models were constructed to examine the impact of psychotic disorders and demographic and clinical characteristics on four discharge dispositions--routine discharge, home care, nursing facility, or in-hospital mortality--among patients with or without a psychotic disorder.
  
  
  RESULTS
  Patients with a psychotic disorder (N=23,751) were significantly more likely than those without a psychotic disorder (N=2,310,379) to be discharged to home care (OR=1.60) or to a nursing facility (OR=4.49) or to die in the hospital (OR=1.95). Patients with a psychotic disorder were more likely than patients without a psychotic disorder to be discharged to a nursing facility if they were also male (OR=4.96), between 65 and 74 years old (OR=6.05), or admitted from another inpatient facility (OR=6.14) or if their illness was of mild or moderate severity (OR=4.87).
  
  
  CONCLUSIONS
  The significantly increased likelihood for referral to skilled home care and nursing facilities after hospital discharge among psychotic patients highlights the need for viable and dynamic community-based care options for maintaining the health and well-being of older adults with a psychotic disorder after an acute care event.
authors.affiliation: Graduate School of Social Work and Social Research, Bryn Mawr College, 300 Airdale Rd., Bryn Mawr, PA 19010, USA. snath@brynmawr.edu
authors.forename: Sara Bressi
authors.initials: SB
authors.lastname: Nath
authors.forename: Steven C
authors.initials: SC
authors.lastname: Marcus
mesh_terms: D000208:Acute Disease / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D015897:Comorbidity; D005260:Female; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology