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Impact of a Multidisciplinary Dementia Support Care Team on Readmission Outcomes in Older Inpatients: A Retrospective
Takenori Okumura1,2, Hiroshi Yoshino2, Hajime Takechi2
1Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan.
Background:
Dementia is a global health issue that affects medical and long-term care systems. The Dementia Support Care Team (DST) was introduced in Japan to support hospitalised patients through multidisciplinary care. Its impact on subsequent admissions remains unclear. This study evaluated associations between prior DST support and clinical characteristics.
Methods:
This retrospective observational study included patients admitted to Fujita Health University Hospital who received DST support. Patients were categorised into two groups based on prior DST support. Multiple regression analysis was performed using the log-transformed length of hospital stay as the dependent variable. Independent variables included age, sex, interval between admissions, laboratory data, and clinical variables. Propensity scores were estimated using logistic regression, with prior DST support as the dependent variable and age, serum albumin levels, 4AT score, interval between admissions, long-term care insurance use, nursing facility use, and history of dementia diagnosis as covariates. Propensity score matching was performed using 1:1 nearest-neighbour matching with a calliper width of 0.2 without replacement.
Results:
Among 271 patients analysed, those with prior DST support had significantly shorter hospital stays (18.0 days [IQR: 10.0-29.0] vs. 26.0 days [IQR: 15.0-48.3]; p < 0.001). Multiple regression analysis showed that prior DST support (β = -0.34, 95% CI: -0.53 to -0.16), serum albumin levels (β = -0.35, 95% CI: -0.49 to -0.20), physical restraint (β = 0.21, 95% CI: 0.03 to 0.38), and living alone (β = 0.45, 95% CI: 0.14 to 0.77) were significantly associated with log-transformed length of hospital stay. After propensity score matching, hospital stays remained significantly shorter (20 days [IQR: 11-30] vs. 21 days [IQR: 15-42]; p = 0.037).
Conclusions:
Prior DST support was associated with shorter hospital stays and differences in clinical characteristics during subsequent hospitalisations.
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