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Increased risk of nursing home admission among middle aged and older adults with schizophrenia.
- Source :
-
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2009 Aug; Vol. 17 (8), pp. 697-705. - Publication Year :
- 2009
-
Abstract
- Objective: Cross-sectional data indicate that persons with serious mental illness have increased risk of institution-based care, yet little is known about the long-term course of nursing home placement for persons with schizophrenia. This study describes nursing home entrance over a 10-year period among community residing Medicaid enrollees with schizophrenia compared with Medicaid enrollees with no mental illness.<br />Methods: The authors analyzed claims of 7,937 New Hampshire Medicaid beneficiaries aged 40 and older. Claims were followed annually from 1996 to 2005 to determine nursing home admission. Schizophrenia was identified from International Classification of Diseases: 9th Edition codes and used to model nursing home admission controlling for medical severity, physical disability, sex, and age. Cox proportional hazard models were run for the entire sample and then separately for middle-aged (40-64 years) and older-aged (65 years and older) subgroups.<br />Results: Persons with schizophrenia enter nursing homes earlier (median age 65) than persons with no mental illness (median age: 80). The greatest relative disparity occurs at middle age (40-64 years), where nursing home admission risk was 3.90 (95% confidence interval = 2.86-5.31) times greater for persons with schizophrenia than for persons with no mental illness.<br />Conclusions: Middle-aged persons with schizophrenia have almost four times greater likelihood of early institutionalization in nursing homes compared with their same age peers with no mental illness. Efforts to prevent/reduce unwarranted nursing home admission among persons with schizophrenia should focus on health status in the fifth decade of life.
- Subjects :
- Adult
Aged
Aged, 80 and over
Case-Control Studies
Cross-Sectional Studies
Female
Geriatric Assessment
Humans
Institutionalization statistics & numerical data
Length of Stay statistics & numerical data
Male
Medicaid
Middle Aged
Proportional Hazards Models
Psychiatric Status Rating Scales
Risk Assessment
Risk Factors
Schizophrenia diagnosis
Surveys and Questionnaires
United States epidemiology
Aging psychology
Nursing Homes statistics & numerical data
Patient Admission statistics & numerical data
Schizophrenia epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1545-7214
- Volume :
- 17
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 19625787
- Full Text :
- https://doi.org/10.1097/JGP.0b013e3181aad59d