title: Acute hospital care: how much activity is attributable to caring for patients with dementia?
abstract: BACKGROUND
  People with dementia are among the most frequent service users in the acute hospital. Despite this, the acute hospital is not organized in a manner that best addresses their needs.
  
  
  METHODS
  We examined acute dementia care over a 3-year period from 2010 to 2012 in a 600-bed university hospital, to clarify the service activity and costs attributable to acute dementia care.
  
  
  RESULTS
  Nine hundred and twenty-nine patients with dementia were admitted during the study period, accounting for 1433/69 718 (2%) of all inpatient episodes, comprising 44 449/454 169 (10%) of total bed days. The average length of stay was 31.0 days in the dementia group and 14.1 days in those >65 years without dementia. The average hospital care cost was almost three times more (€13 832) per patient with dementia, compared with (€5404) non-dementia patients, accounting for 5% (almost €20 000 000) of the total hospital casemix budget for the period.
  
  
  CONCLUSIONS
  Service activity attributable to dementia care in the acute hospital is considerable. Moreover, given the fact that a significant minority of cognitive impairment goes unrecognized after acute admissions, it is likely that this is under-representative of the full impact of dementia in acute care. Although the money currently being spent on acute dementia care is considerable, it is being used to provide a service that does not meet its user needs adequately. It is clear that acute hospitals need to provide a more 'dementia friendly' service for acutely unwell older persons.
authors.affiliation: From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and.
authors.forename: R
authors.initials: R
authors.lastname: Briggs
authors.affiliation: From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and.
authors.forename: R
authors.initials: R
authors.lastname: Coary
authors.affiliation: From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Collins
authors.affiliation: From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: T
authors.initials: T
authors.lastname: Coughlan
authors.affiliation: From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: O'Neill
authors.affiliation: From the Department of Age-Related Health Care, Tallaght Hospital, Dublin, Ireland and Department of Medical Gerontology, Trinity College, Dublin, Ireland sean.kennelly@amnch.ie.
authors.forename: S P
authors.initials: SP
authors.lastname: Kennelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000628:therapy*; D003704:Dementia / Q000150:complications / Q000628:therapy*; D004632:Emergency Medical Services / Q000191:economics*; D005260:Female; D017721:Hospital Costs / Q000639:trends*; D006785:Hospitals, University; D006801:Humans; D007494:Ireland; D007902:Length of Stay / Q000191:economics*; D008297:Male