Association between Depressive disorder and hospital outcomes of care for elderly hospitalized patients

Abstract

Depressive disorder is the most prevalent mental health issue among the elderly. Researchers have studied associations between poor outcomes of health and depressive disorder. However, there is limited knowledge on the association of depressive disorder on hospital outcomes of care for patients admitted due to acute health problems. This study utilized a large dataset from the Centers for Medicare and Medicaid Services to examine associations between depressive disorder and (i) length of stay, (ii) hospital mortality, and (iii) hospital-acquired septicemia, for hospitalized Medicare patients 65 years and above. Bivariate analysis was firstly conducted between each one of the outcomes of interest and the depressive disorder variable, and then, to control for demographics, primary diagnosis, and comorbidities, multiple logistic regression was conducted for the binary outcomes (hospital mortality and hospital-acquired septicemia) and multiple linear regression for the continuous outcome, Length of Stay. After adjusting for patient gender, ethnicity, primary diagnosis, and comorbidities, the presence of depressive disorder in elderly Medicare patients was found to be associated with increased odds for hospital death (OR = 1.186, C. I = 1.030—1.365), and a shorter hospital length of stay (b = -.697, p < 0.001). Black race was found to be protective for death for patients with depressive disorder. Since depression has an effect on various behavioral aspects of patients, the increased risk for hospital death underlines the need for a holistic patient care approach for acute patients with depression, including psychologic support, effective patient-therapist communication, and patient empowerment.