Behavioral Issues Impact Hospitalization Risk: Study

October 25, 2019

Residents of nursing centers who have behavioral health disorders (BHD) have a significantly higher risk of potentially unavoidable hospital admissions, according to a new study in the October issue of JAMDA. The study also found that residents with Alzheimer’s disease or related dementias (ADRD) had a lower risk of both potentially avoidable and potentially unavoidable hospitalizations.

Behavioral health disorders may include schizophrenia, bipolar disorder, depression, and substance abuse, the researchers said.

Researchers identified a total of 439,822 hospitalizations overall for long-stay nursing center residents and reviewed nationwide claims data and assessment data for 2014 and 2015, including Minimum Data Sets. Individuals with ADRD (with or without BHD) were less likely to have any hospitalizations compared with those with neither ADRD or BHD or BHD alone. In addition, the proportion of potentially avoidable hospitalizations was lowest among those with ADRD only.

Policy makers at both federal and state levels have increasingly targeted avoidable hospitalizations as a means to cut down on Medicare costs. Given the findings, the authors cautioned that state and national initiatives to improve quality and/or cost efficiencies in nursing centers may have unintended and negative consequences for individuals with ADRD and BHD, and that further study is needed to “better understand how such initiatives impact these most vulnerable of residents.”

JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. The study was completed by researchers at the Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, N.Y., and the Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY.

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