A comparative analysis of dementia inpatient characteristics: results from a nationwide survey of different care facilities in Japan.

BACKGROUND: In Japan, the number of dementia patients admitted to hospitals and other care facilities has been increasing and their hospital stays prolonged. Until now, there has been no study examining the differences between patients in psychiatric hospitals and other care facilities. Here we attempt a comparative analysis of characteristics of dementia patients in psychiatric hospitals and other types of facilities based on a nationwide survey. METHOD: A nationwide, cross-sectional survey was conducted in 2009-2011. Questionnaires were sent to randomly selected facilities and asked about each facility's status as of September 2009 and about individuals with dementia residing in each facility during the 2008 fiscal year. The portion about individuals consisted of items to assess eligibility for the Long-Term Care Insurance programme. Based on data from 6121 patients residing in seven different types of facilities, features of dementia patients in psychiatric hospitals and differences among facilities were analyzed. RESULTS: There was a significant difference in average age, activities of daily living level, and dementia severity level among the seven types of facilities. The average age in all types of facilities, except for psychiatric hospitals, was higher than the national average life expectancy of 82.59 years. The results of the study revealed that in psychiatric hospitals the proportion of men, those aged <75 years, demented patients with severe behavioural and psychological symptoms of dementia, and those with frontotemporal dementia was significantly greater than in other types of facilities. In other Long-Term Care Insurance care facilities, dementia patients >80 years and women accounted for 80% of all patients. CONCLUSION: Result showed that dementia patients in psychiatric hospitals had a higher proportion of men, younger age groups, and severe dementia than other types of facilities. These features contrast markedly with status of dementia patients in other Long-Term Care Insurance care facilities. In order to facilitate dementia patients' early discharge from psychiatric hospitals to other care facilities or to home, further fulfillment care services corresponding to severe dementia and early-onset dementia may be needed.