Psychiatric Comorbidity and Greater Hospitalization Risk, Longer Length of Stay, and Higher Hospitalization Costs in Older Adults with Heart Failure

摘要: OBJECTIVES: To explore associations between psychi-atriccomorbidityandrehospitalizationrisk,lengthofhospi-talization, and costs.DESIGN: Cross-sectional study of 1-year hospital admin-istrative data.SETTING: Claims-basedstudyofolderadultshospitalizedin the United States.PARTICIPANTS: Twenty-one thousand four hundredtwenty-nine patients from a 5% national random sampleof U.S. Medicare beneficiaries aged 65 older, with atleast one acute care hospitalization in 1999 Diag-nostic-Related Group congestive heart failure.MEASUREMENTS: The number hospitalizations,mean length stay, total costsin calendar year 1999.RESULTS: Overall, 15.8% hospitalized forheart failure (HF) had coded psychiatric comorbidity; themost commonly comorbid disorder wasdepression (8.5%of sample). Most forms psychiatriccomorbidity were associated greater inpatient utiliza-tion, including risk additional hospitalizations, days ofstay, charges. Additional hospitaliza-tion costs comorbidity rangedup to $7,763, stay ranged upto 1.4 days.CONCLUSION: Psychiatric appears sig-nificant minority for HF mayaffecttheirclinicalandeconomicoutcomes.Theassociationsbetweenpsychiatriccomorbidityanduseofinpatientcarearelikely be an underestimate, because illness isknowntobeunderdetectedinolderadultsandinhospitalizedmedical patients. J Am Geriatr Soc 55:1585–1591, 2007.Key words: failure; comorbidity;depression; costs; economic analysis;Medicare; sex; socioeconomic status; race/ethnicity