Hospitalizations for People Aging with Schizophrenia

TL;DR

This study examines hospitalization patterns and outcomes for older adults with schizophrenia, finding longer stays and higher readmission rates.

Contribution

The study provides new insights into hospitalization trends and readmission factors for aging individuals with schizophrenia in rural hospitals.

Findings

Hospitalizations for those over 65 with schizophrenia had a significantly longer length of stay compared to younger patients.

Men with schizophrenia had longer hospital stays than women.

Readmission rates were high, with reasons unrelated to schizophrenia dominating.

Abstract

Aging with schizophrenia or schizoaffective disorder is associated with high mortality. Quality of acute care in general hospital systems for older adults with long-term psychiatric conditions like schizophrenia and schizoaffective disorders is not well studied. After IRB approval, we extracted real-world data from 9,868 persons with a diagnosis of schizophrenia/schizoaffective disorder (62% female and 38% male) who received care in a midwestern, rural-designated hospital in the past 5 years. The majority were single and dismissed to self-care/home at an average age of 49 years. The length of stay for those over 65 (length of stay mean = 11.2 days) compared to under 65 (length of stay mean = 10.16) years of age was significantly (p = 0.008) higher. The length of hospitalization for men (11.97) was also higher than for women (9.35; p < 0.001). There were 17% with a 30-day readmission; the top readmission diagnoses included: shortness of breath, chest pain of unspecified type, and suicidal ideation, the same top three reason for initial admission. Chief complaints were non-specified in 42% of admissions. Over 93% of 30-, 60-, and 90-day readmissions were for reasons other than schizophrenia. Further explorations of quality care delivery, especially sex by age interactions for those with a diagnosis of schizophrenia, are needed.