The efficacy of a comprehensive psychiatric program on nursing home patients
Margolis, Susan Ellen
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The purpose of this retrospective, descriptive study was two-fold: (a) the first was to evaluate the effect of a comprehensive psychiatric program in nursing homes on psychiatric hospitalization rates of those nursing home psychiatric patients who do and do not receive regular comprehensive psychiatric care, and (b) to examine the financial burden each group placed on the health care system. The study sample consisted of 236 subjects, 65 years or older, who had a psychiatric diagnosis. The program group consisted of 49 subjects located in one of three nursing homes. The program group received comprehensive psychiatric care in the nursing home. The non-program (control) group consisted of 187 subjects who were also located in one of the same three nursing homes. All 236 patients had psychiatric diagnoses, but only 49 were referred to the program. Psychiatric hospitalization rates of the program and non-program groups were compared in each of the four quarters in 1998. A Theta coefficient for nominal-ordinal data was computed to test this hypothesis and found no statistical significance. The program group had hospitalizations for only the first quarter of 1998, whereas the non-program group had hospitalizations for 50% (half) of the year. The actual number of subjects admitted for psychiatric hospitalizations was the same in each group. There was no statistical significance between the two groups; however, there was clinical significance. Treatment costs for patients receiving comprehensive psychiatric care in the nursing home was predicted to be less than the costs for non-program patients. The total number of hospitalizations and their associated costs for both groups were found to be equal. Medical diagnoses and physical deficits (communication, hearing, mobility, and vision impairments) were examined by treatment groups. Heart disease was found in more of the program patients. The non-program patients had more physical impairments (communication, hearing, and vision), although the program group had a larger percentage of patients with mobility deficits.