Mapping the elder mistreatment iceberg: U.S. hospitalizations with elder abuse and neglect diagnoses.
J Elder Abuse Negl
; 21(4): 346-59, 2009 Oct.
Article
in En
| MEDLINE
| ID: mdl-20183139
ABSTRACT
PURPOSE:
This study describes U.S. hospitalizations with diagnostic codes indicating elder mistreatment (EM).METHOD:
Using the 2003 Nationwide Inpatient Sample (NIS) of the Healthcare Costs and Utilization Project (HCUP), inpatient stays coded with diagnoses of adult abuse and/or neglect are compared with stays of other hospitalized adults age 60 and older.RESULTS:
Few hospitalizations (< 0.02%) were coded with EM diagnoses in 2003. Compared to other hospitalizations of older adults, patients with EM codes were twice as likely to be women (OR = 2.12, 95% CI = 1.63-2.75), significantly more likely to be emergency department admissions (78.0% vs. 56.8%, p < .0001), and, on average, more likely to have longer stays (7.0 vs. 5.6 days, p = 0.01). Patients with EM codes were also three to four times more likely to be discharged to a facility such as a nursing home rather than "routinely" discharged (i.e., to home or self-care) (OR = 3.66, 95% CI = 2.92-4.59). Elder mistreatment-coded hospitalizations compared to all other hospitalizations had on average lower total charges ($21,479 vs. $25,127, p < .001), with neglect cases having the highest charges in 2003 ($29,389). IMPLICATIONS Knowledge about EM is often likened to the "tip of the iceberg." Our study contributes to "mapping the EM iceberg"; however, findings based on diagnostic codes are limited and should not be used to minimize the problem of EM. With the so-called graying of America, training is needed in recognizing EM along with research to improve our nation's response to the mistreatment of our elderly population.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Elder Abuse
/
Hospitalization
Type of study:
Diagnostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
J Elder Abuse Negl
Journal subject:
GERIATRIA
Year:
2009
Document type:
Article
Affiliation country:
United States