Factors related to day-care clinic outcomes for dementia patients: differences between hospitalization in the dementia ward and institutionalization

• Published in: Psychogeriatrics 2014-03, Vol.14 (1), p.17-24
• Main Authors: Ono, Toshiyuki, Tamai, Akira, Takeuchi, Daisuke, Tamai, Yuzuru
• Format: Article
• Language: English
• Subjects: Adult day care; Age Distribution; Aged; Aged, 80 and over; Cognitive ability; day care; Day Care, Medical - methods; Day Care, Medical - psychology; Day Care, Medical - statistics & numerical data; Dementia; Dementia - nursing; Dementia - psychology; factor of outcome; Female; Geriatric Assessment - methods; Geriatric Assessment - statistics & numerical data; Hospitalization; Hospitalization - statistics & numerical data; Humans; institutionalization; Institutionalization - methods; Institutionalization - statistics & numerical data; Male; Mental institutions; Older people; Outcome Assessment (Health Care) - methods; Outcome Assessment (Health Care) - statistics & numerical data; Psychiatric Department, Hospital - statistics & numerical data; Retrospective Studies; Severity of Illness Index; Sex Distribution
• ISSN: 1346-3500; 1479-8301
• DOI: 10.1111/psyg.12034

Background Few reports have investigated factors related to the outcomes of day‐care attendance. The aim of this retrospective study was to investigate the factors related to the outcomes of patients who attended day‐care clinics, with special attention to the differences between hospitalization in the dementia ward and institutionalization. Methods We analyzed data from 333 patients in consecutive cases who attended day care between 1 April 2000 and 31 March 2010 and then followed them until 31 March 2011. For univariate and multivariate analyses, patients were divided into seven groups characterized by their outcomes: (i) patients who continued day‐care attendance (continued); (ii) those hospitalized for physical problems (hospital (physical)); (iii) those hospitalized in the dementia ward (ward (dementia)); (iv) those hospitalized in the psychiatric ward for psychiatric problems (ward (psychiatric)); (v) those institutionalized (institution); (vi) those who stopped day‐care attendance by choice (intention); and (vii) those who stopped day‐care attendance for other or unknown reasons (others). Results Behavioural and psychological symptoms of dementia were the main reasons for hospitalization and institutionalization. Men were easier to hospitalize in the dementia ward. Patients who applied for insurance were more likely to be institutionalized. The differences between patients who were hospitalized (dementia ward) and institutionalized were age and cognitive function. Conclusions Patients who were older and had high cognitive function were institutionalized rather than hospitalized in the dementia ward. Patients with severe dementia symptoms were advised to be treated in the dementia ward.