Morbidity of Homebound Versus Inpatient Elderly Psychiatric Patients
|Rona Pasternak a2, Andrew Rosenweig a3, Bridget Booth a1, Andrea Fox a1, Richard Morycz a1, Benoit Mulsant a1, Robert Sweet a1, George S. Zubenko a1, Charles F. Reynolds III a1 and M. Katherine Shear a1|
a1 University of Pittsburgh School of Medicine, Western Psychiatry Institute and Clinic, Pittsburgh, Pennsylvania, USA
a2 Thomas Jefferson University, Philadelphia, Pennsylvania, USA
a3 W. A. Foote Hospital, Jackson, Michigan, USA
This study compares the demographic and clinical characteristics of homebound (HB) elders referred for psychiatric services (N = 251) with those of inpatients (IP) admitted to a geriatric psychiatry unit (N = 594). Demographically, HB patients were older (78.8 vs. 74.7 years), were more likely to be women (83% vs. 68%), were widowed (54% vs. 44%), and had fewer years of education (10.3 vs. 11.1), but were similar in race, income, and proportion living alone. Clinically, HB patients had less functional disability, less severe depression, less cognitive impairment, and fewer medical problems. However, they were similar in the distribution of most psychiatric diagnoses except dementia (higher in the IP group) and dementia with depression (higher in the HB group). Outcome data for the HB group over 15 (range, 1 to 38) months revealed medical hospitalization in 20.7%, psychiatric hospitalization in 16.3%, nursing home placement in 9.2%, and mortality in 8.4%. These preliminary data show that the HB group had psychiatric problems that were comparable to those of the IP group but were not as severely impaired.
(Received July 22 1997)
(Accepted March 9 1998)