Over the last decade more children and teenagers and fewer seniors have been admitted to hospital for short stays for a primary psychiatric diagnosis, a researcher from the Stony Brook University School of Medicine, State University of New York wrote in Archives of General Psychiatry.
The author added that private health insurance appears to be covering a smaller proportion of inpatient days among all age groups.
Overall, there was an increase from 1970 through the 1990s in short-stay inpatient care for psychiatric conditions, while long-term stays dropped during the same period, the researcher explained. From the 1990s until the turn of the millennium, less has been spent in short-stay settings as policy makers and mental health advocates stressed the value of treatment alternatives with less restrictiveness and less negative stigma. According to various data, however, over recent years there has been a slight increase.
Joseph C. Blader, Ph.D. gathered data on acute care hospitalizations from the National Hospital Discharge Survey for primary psychiatric diagnoses between 1996 and 2007. Patients were classified as aged 5 to 13 (children), 14 to 19 (adolescents), 20 to 64 (adults) and 65+ (seniors). Payers were broken down into private, government or other (self pay, no charge and other payment).
After evaluating data on discharges, the author found there had been an increase in numbers for children and adolescents, and also a slight increase for adults. However, numbers dropped among elderly patients.
Below are details on total inpatient days (days per 1,000,000):
- Children – 1,845 days in 1996, and 4,370 days in 2007
- Adolescents – 5,882 days in 1996, and 8,247 days in 2007
- Seniors – 10,348 days in 1996, and 6,517 days in 2007.
Among children, adolescents and adults the percentage of inpatient days covered by private payers dropped during the years studied. The author added that during the same period primary diagnoses of bipolar disorder rose while primary diagnoses of anxiety fell.
“In conclusion, a substantial increase in acute care psychiatric hospitalization rates and inpatient occupancy for children and adolescents, a moderate increase in the hospitalization rate of adults, and a steep decline for elderly individuals represent significant developments in mental health treatment in the United States with potentially strong ramifications for quality of care and service financing. Investigation of the clinical and organizational determinants of these trends, and their impact on patient outcomes, are vital to understanding their implications.”
Written by Christian Nordqvist