Abstract

Objective

To estimate the additional impact of dementia on in-patient length of stay (LOS) and related costs in Irish acute hospitals. Both principal and secondary diagnosis effects are estimated and valued.

Methods

This is a cross-sectional study based on administrative data collected on all public hospital in-patient discharges in Ireland for people aged 65 years and older in 2019. Coarsened exact matching (CEM) was undertaken to account for observed confounders between dementia and non-dementia groups, while generalised linear modelling (GLM) was used to compare differences in LOS.

Results

Patients with a principal diagnosis of dementia spent on average 17.5 (CI: 15.42, 19.56; p < .01) d longer in hospital than similar patients with no principal diagnosis of dementia. LOS was 6.7 (CI: 6.31, 7.14; p < .01) d longer for patients with a secondary diagnosis of dementia compared to similar patients with no secondary diagnosis of dementia. The additional annual cost of care for patients in hospitals with a secondary (principal) diagnosis of dementia was €62.0 million (€13.2 million).

Conclusions

This study highlights the economic impact of extended LOS for patients with dementia in Irish acute hospitals. Addressing specific dementia-related needs of people in hospital is likely to optimise resource use and decrease health care costs in acute care settings.

中文翻译：

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爱尔兰急症护理医院与痴呆症相关的住院时间延长和相关费用

摘要

客观的

估计痴呆症对爱尔兰急症医院住院时间 (LOS) 和相关费用的额外影响。估计和评估主要和次要诊断效果。

方法

这是一项基于 2019 年爱尔兰所有公立医院住院患者出院管理数据的横断面研究。采用粗化精确匹配 (CEM) 来解释观察到的痴呆症和非痴呆症患者之间的混杂因素痴呆组，而广义线性模型 (GLM) 用于比较 LOS 的差异。

结果

与主要诊断为痴呆症的患者 相比，主要诊断为痴呆症的患者平均住院时间长 17.5 (CI: 15.42, 19.56; p < .01) d。 与没有痴呆症二次诊断的类似患者相比，二次诊断为痴呆症的患者的LOS 长 6.7 (CI: 6.31, 7.14; p < .01) d。二次（主要）痴呆症患者在医院的额外年度护理费用为 6200 万欧元（1320 万欧元）。

结论

本研究强调了延长 LOS 对爱尔兰急症医院痴呆症患者的经济影响。解决住院患者与痴呆症相关的特定需求可能会优化资源利用并降低急症护理环境中的医疗保健成本。