Influence of dementia-specialized care team on clinical outcomes in a general hospital.

Autor: Shimomura Y; Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan; Yokohama Municipal Citizen's Hospital, Department of Psychiatry, Kanagawa, Japan., Nishimura W; Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan; Yokohama Municipal Citizen's Hospital, Department of Psychiatry, Kanagawa, Japan., Murayama M; Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan; Yokohama Municipal Citizen's Hospital, Department of Psychiatry, Kanagawa, Japan; Asaka Hospital, Department of Psychiatry, Fukushima, Japan., Yoshimura K; Keio University School of Medicine, Department of Health Policy and Managements, Tokyo, Japan., Mimura M; Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan., Uchida H; Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan., Takeuchi H; Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan. Electronic address: hirotak@dk9.so-net.ne.jp., Shishida K; Yokohama Municipal Citizen's Hospital, Department of Psychiatry, Kanagawa, Japan.
Jazyk: angličtina
Zdroj: Asian journal of psychiatry [Asian J Psychiatr] 2024 Dec; Vol. 102, pp. 104256. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1016/j.ajp.2024.104256
Abstrakt: Background: Because of the increasing prevalence of dementia in Japan, the government introduced financial incentives for specialized care for dementia at acute care hospitals in 2016. Our hospital then introduced a multidisciplinary collaborative specialized team, referred to as dementia-specialized care team. The aim of this study is to examine the influence of dementia-specialized care team on clinical outcomes for elderly inpatients.
Methods: In this retrospective observational study at a general hospital with 650 beds in Japan, we compared clinical outcomes such as incidence of falls, prescription of hypnotics, length of hospital stay, in-hospital mortality, and discharge destinations in inpatients aged 65 years and older between a two-year pre-intervention period (2014-2015) and a two-year post-intervention period (2017-2018).
Results: During the observation period, a total of 34,097 patients were admitted, with 16,237 patients in the pre-intervention period and 17,860 patients in the post-intervention period. The proportion of patients receiving any hypnotics decreased from 21.2 % to 19.2 %, notably with benzodiazepine from 19.8 % to 13.2 %. The incidence of falls from a seated or lying position, particularly at night, was significantly lower (from 0.5 % to 0.2 %) as was the length of hospital stay (from 13.7 days to 13.2 days) during the post-intervention period.
Conclusion: After the implementation of dementia-specialized care team, favorable outcomes such as a reduction in the use of hypnotics, the incidence of falls, and the length of hospitalization were observed. Introduction of the team and associated incentives may be effective in improving clinical outcomes in elderly inpatients.
Competing Interests: Declaration of Competing Interest Drs. Shimomura, Nishimura, Murayama, and Yoshimura have no conflicts of interest. Dr. Mimura has received grants from Daiichi Sankyo, Eisai, Fronteo, Mitsubishi Tanabe Pharma, Shionogi, Takeda, and Tsumura; and speaker’s fees from Biogen, Byer, Daiichi Sankyo, Demant, Eisai, Eli Lilly, Fujifilm RI Pharma, Hisamitsu, H.U. Frontier, Janssen, Mochida, MSD, Mylan EPD, Nippon Chemipher, Novartis Pharma, Ono, Otsuka, Pfizer, Shionogi, Sumitomo Pharma, Takeda, Teijin Pharma, and Viatris. Dr. Uchida has received grants from Daiichi Sankyo, Eisai, Mochida, Otsuka, and Sumitomo Pharma; speaker’s fees from Boehringer Ingelheim, Eisai, Lundbeck, Meiji Seika Pharma, Otsuka, MSD, and Sumitomo Pharma; and consulting fees from Boehringer Ingelheim, Lundbeck, Sumitomo Pharma, and Takeda. Dr. Takeuchi has received grants from Daiichi Sankyo, Novartis Pharma, and Otsuka; speaker fees from EA Pharma, Eisai, Janssen, Kyowa, Lundbeck, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka, Sumitomo Pharma, Takeda, and Yoshitomiyakuhin; and consulting fees from Boehringer Ingelheim, Janssen, Mitsubishi Tanabe Pharma, Ono, and Sumitomo Pharma. Dr. Shishida has received speaker’s fee from MSD and Sumitomo Pharma.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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