Patients with dementia in hospitals: a nation-wide analysis of administrative data 2010–2014

Key summary points Aim Objectify the hospital capacity use of patients with dementia. Findings Patients with dementia were mostly admitted through the emergency department and their in-hospital mortality was high in the first days of admission. They had longer lengths of stay than other patients of the same age admitted for the same pathologies, and they stayed even longer when admitted from home and discharged to a residential care facility. Message Inappropriate hospital admission policy of patients with dementia calls for investments in adequate capacity, workforce and the development of geriatric expertise in the Belgian hospital sector, the residential care setting and in community care. Purpose Considering the limited information available, the aim of the study was to examine the prevalence and characteristics of inpatients with dementia in Belgian general hospitals. Methods All admissions of inpatients aged at least 40 years with or without dementia were retrieved from the nationwide administrative hospital discharges database for the period 2010–2014. Results Admissions of inpatients aged 40 years or more with dementia have increased to reach 83,017 out of 1,285,593 admissions (6.46%) in general hospitals in 2014, mostly admitted through the emergency department (79.7%) and for another reason than dementia (85.9%). These patients stayed longer [19.2 days, standard deviation (sd) = 23.6, median = 13] than the average length of stay of patients of the same age (7.9 days, sd = 14.1, median = 17). Considering patients aged 75 years or more falling into the 20 most common pathology groups (of patients with dementia), the group with dementia spent 5 days more than the group without dementia. Patients admitted from home spent more time in hospital when they were discharged to a residential care facility than when they returned home (27.2 days versus 15.8 days). The in-hospital mortality was high in the first days of admission. Conclusions The growing prevalence of patients with dementia in inpatient setting puts a high pressure on the hospital capacity planning and geriatric expertise. Moreover, as patients with dementia should be kept outside hospitals when possible for safety and quality matters, long-term organizational investments are required inside hospital and residential care settings as well as in community care.