@article{ref1,
title="Mapping the elder mistreatment iceberg: U.S. hospitalizations with elder abuse and neglect diagnoses",
journal="Journal of elder abuse and neglect",
year="2009",
author="Rovi, Susan L. D. and Chen, Ping-Hsin and Vega, Marielos and Johnson, Mark S. and Mouton, Charles P.",
volume="21",
number="4",
pages="346-359",
abstract="PURPOSE: This study describes U.S. hospitalizations with diagnostic codes indicating elder mistreatment (EM). METHOD: Using the 2003 Nationwide Inpatient Sample (NIS) of the Healthcare Costs and Utilization Project (HCUP), inpatient stays coded with diagnoses of adult abuse and/or neglect are compared with stays of other hospitalized adults age 60 and older. RESULTS: Few hospitalizations (< 0.02%) were coded with EM diagnoses in 2003. Compared to other hospitalizations of older adults, patients with EM codes were twice as likely to be women (OR = 2.12, 95% CI = 1.63-2.75), significantly more likely to be emergency department admissions (78.0% vs. 56.8%, p < .0001), and, on average, more likely to have longer stays (7.0 vs. 5.6 days, p = 0.01). Patients with EM codes were also three to four times more likely to be discharged to a facility such as a nursing home rather than &quot;routinely&quot; discharged (i.e., to home or self-care) (OR = 3.66, 95% CI = 2.92-4.59). Elder mistreatment-coded hospitalizations compared to all other hospitalizations had on average lower total charges ($21,479 vs. $25,127, p < .001), with neglect cases having the highest charges in 2003 ($29,389). IMPLICATIONS: Knowledge about EM is often likened to the &quot;tip of the iceberg.&quot; Our study contributes to &quot;mapping the EM iceberg&quot;; however, findings based on diagnostic codes are limited and should not be used to minimize the problem of EM. With the so-called graying of America, training is needed in recognizing EM along with research to improve our nation's response to the mistreatment of our elderly population.<p /><p>Language: en</p>",
language="en",
issn="0894-6566",
doi="10.1080/08946560903005109",
url="http://dx.doi.org/10.1080/08946560903005109"
}