The association of individual and facility characteristics with psychiatric hospitalization among nursing home residents

Objective To examine resident and facility characteristics associated with psychiatric hospitalizations (PH) for Medicaid enrolled nursing home (NH) residents. Methods Participants were all Medicaid enrolled NH residents (n = 32,604) from all Medicaid certified nursing homes in Florida (n = 584) with complete data. We used individual demographic and diagnostic characteristics, as well its facility characteristics, to explore risk of psychiatric hospitalization in this dataset. Results Using generalized estimating equations, we found that younger age, male gender, poor physical health, serious mental illness, dementia, and drug use disorder were associated with risk of psychiatric hospitalization. Most notably, residents under 65 were more than three times more likely to undergo psychiatric hospitalization and dementia wits associated with it three-fold increase in the risk of psychiatric hospitalization. Predictors of PH differed somewhat for younger and older resident. Among facility characteristics, greater facility size, low proportion of those paying via Medicare and high proportion of residents with serious mental illness were associated with increased risk of psychiatric hospitalization, whereas, low proportion of residents paying vial Medicaid, high proportion of residents paying via Medicare, and low proportion of resident with serious mental illness were associated with reduced risk. Conclusions Both resident and facility characteristics impact risk for psychiatric hospitalization. Attention to identified predictors tray reduce risk and improve outcomes for nursing home residents. Copyright (C) 2009 John Wiley & Sons, Ltd.