Do ward changes affect outcomes differently in people living with dementia?

Area of Science:

• Gerontology
• Healthcare Management
• Dementia Care

Background:

• Hospital ward changes are linked to adverse outcomes in older adults.
• The specific impact of ward changes on individuals with dementia remains under-researched.

Purpose of the Study:

• To investigate whether individuals with dementia experience more negative effects from hospital ward changes compared to other older adults.
• To analyze the association between ward transfers, dementia status, and patient outcomes.

Main Methods:

• Service evaluation conducted in four UK NHS Trust hospitals.
• Included data from 27,140 admissions (19,392 individuals, 2760 with dementia) aged 65 years and older.
• Generalized estimating equations used to model length of stay, inpatient mortality, and discharge to care home, adjusting for demographic and socioeconomic factors.

Main Results:

• Ward changes and the interaction with dementia were significantly associated with a longer length of stay (LOS).
• Dementia increased mortality risk, but ward changes did not interact with dementia status regarding mortality.
• Both dementia and ward changes independently increased the risk of discharge to a care home, without evidence of interaction.

Conclusions:

• Ward changes disproportionately extend the length of stay for individuals with dementia.
• Minimizing ward transfers is crucial for improving outcomes in older adults, especially those with dementia, to reduce extended LOS and potential inpatient harm.