title: Quality of care for people with dementia in general hospitals: national cross-sectional audit of patient assessment.
abstract: There have been recent reports of poor quality care in the National Health Service in the UK, and older people with dementia are particularly vulnerable. This study aims to examine the quality of assessment of people with dementia admitted to hospital. Cross-sectional case-note audit of key physical and psychosocial assessments was carried out in 7,934 people with dementia who were discharged from 206 general hospitals. Most people had no record of a standardised assessment of their cognitive state (56.8%, 95% confidence interval [CI] = 55.8-58.0) or functioning (74.2%, 95% CI = 73.2-75.1). Information from carers was documented in 39.0% of cases (95% CI = 37.9-40.1). There was considerable variation across hospital sites. Key assessments were less likely when people were admitted to surgical wards. Assessments fall well below recommended standards especially with regard to social and cognitive functioning. Problems are particularly marked on surgical wards.
authors.affiliation: College Centre for Quality Improvement, Royal College of Psychiatrists, London, UK.
authors.forename: Renata
authors.initials: R
authors.lastname: Souza
authors.affiliation: College Centre for Quality Improvement, Royal College of Psychiatrists, London, UK.
authors.forename: Aarti
authors.initials: A
authors.lastname: Gandesha
authors.affiliation: College Centre for Quality Improvement, Royal College of Psychiatrists, London, UK.
authors.forename: Chloe
authors.initials: C
authors.lastname: Hood
authors.affiliation: College Centre for Quality Improvement, Royal College of Psychiatrists, London, and Oxford Health Foundation NHS Trust, Oxford, UK rchaplin@cru.rcpsych.ac.uk.
authors.forename: Robert
authors.initials: R
authors.lastname: Chaplin
authors.affiliation: Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Leeds, UK.
authors.forename: John
authors.initials: J
authors.lastname: Young
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Crome
authors.affiliation: College Centre for Quality Improvement, Royal College of Psychiatrists, London, and Imperial College London, UK.
authors.forename: Mike J
authors.initials: MJ
authors.lastname: Crawford
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Dementia; assessment; audit; hospital admission; quality improvement