Predictors of length of stay in an acute psychiatric inpatient facility in a general hospital: a prospective study

Baeza, Fernanda Lucia Capitanio; Rocha, Neusa Sica da; Fleck, Marcelo Pio de Almeida

doi:10.1590/1516-4446-2016-2155

Cited by 25 publications

(29 citation statements)

References 22 publications

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“…Our findings show that reasons for hospitalisation, risk to oneself, and incapacity for self-care and/or insufficient family/social support all proved to be strongly associated with LOS in psychiatric patients (OR 3.61 [95% CI, 1.91-6.82]; p < 0.05) with respect to relocation and placement difficulties following discharge among those with severe self-care deficits. Similar results were observed in previous studies conducted in Brazil [12] and other countries [14,15].…”

Section: Discussionsupporting

confidence: 92%

“…The mean LOS in the present study was 50.5 days (SD 31.5), and the median was 41 days (95% CI, 37-45 days). A previous Brazilian study by Baeza et al reported an average stay of 30 days (SD 20.8) with a range of 7-199 days [12]. Tachimori et al [4] used dissimilar criteria and reported different results, thus making it impossible to compare the observed average LOS for mental and behavioural disorders with those in developed countries throughout North America and Europe where LOS varied from approximately 5 days (France and USA) to 40 days (UK).…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric hospitalisation is often long-term and justifiable based on the risks to oneself or others combined with a severe incapacity to provide proper self-care that is exacerbated by the absence or insufficiency of family and/or social support. Mental disorders that may require prolonged psychiatric hospitalisation include schizophrenia [11,12] and major depressive disorder (MDD) [13] because of the risks they pose to affected patients and others. The time interval between the onset of the disorder (often unclear) and the initiation of appropriate treatment can be very long.…”

Section: Introductionmentioning

confidence: 99%

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Length of Stay of Psychiatric Admissions: a Case-Control Study

Scussel

Nunes

2020

SN Compr. Clin. Med.

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To identify the exposure factors associated with the length of stay of psychiatric patients. A case-control study was performed at a psychiatric hospital in Brazil. The cases included all hospitalised patients with stays of over 60 continuous days over a 1-year period. The randomly chosen controls were matched by gender and age. Multivariate analyses using logistic regression were performed. A total of sixteen patients were selected. There were 72 cases (5.5% of all hospitalisations) and 144 controls; 63.9% were male, and the mean age was 44.4 years (± 11.9). The reasons for hospitalisation were risk to self and the inability to provide for self-care coupled with inadequate family/social support that were shown to be associated (p < 0.05) with length of stay of these psychiatric patients. Additional analytical studies to investigate the quality of life of long-term psychiatric hospitalisation patients are recommended.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Length of Stay of Psychiatric Admissions: a Case-Control Study

Scussel

Nunes

2020

SN Compr. Clin. Med.

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“…The most common diagnoses in the total sample were drug-related disorders, followed by mood, alcohol-related and psychotic disorders, but there were important differences across the age groups. There was a linear trend showing an increase in the number of admissions from 2013 to the midst of 2014, which again dropped in 2015 and subsequent years.To the best of the authors' knowledge, this is the first study to investigate the prevalence of people with mental disorders admitted to inpatient care units in a large Brazilian city, whereas previous efforts to estimate rates of inpatient utilization were limited to specific hospital settings,10,11 Brazilian states,[12][13][14] and age groups 15,16. new admissions and new records of the same hospitalization that continued (the unit of analysis is the record, not the individual) 13,15.…”

mentioning

confidence: 99%

Prevalence and trends of mental disorders requiring inpatient care in the city of Porto Alegre: a citywide study including all inpatient admissions due to mental disorders in the public system from 2013-2017

Salum

Leite

Santos

et al. 2020

Trends Psychiatry Psychother.

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Objectives To investigate the 5-year prevalence of patients admitted to public inpatient care units due to a mental disorder, stratifying them by age group and diagnosis, and to assess trends of admissions over this time period in Porto Alegre. Methods All admissions to the public mental health care system regulated by the city-owned electronic system Administração Geral dos Hospitais (AGHOS) were included in the analysis. The total population size was obtained by estimations of Fundação de Economia e Estatística (FEE). General information about 5-year prevalence of inpatient admissions, time-series trends e prevalence by age groups and diagnosis were presented. Results There were 32,608 admissions over the 5-year period analyzed. The overall prevalence of patients was 1.62% among the total population, 0.01% among children, 1.12% among adolescents, 2.28% among adults and 0.93% among the elderly. The most common diagnosis was drug-related, followed by mood, alcohol-related and psychotic disorders. There was a linear trend showing an increase in the number of admissions from 2013 to the midst of 2014, which dropped in 2015. Conclusions Admissions due to mental disorders are relatively common, mainly among adults and related to drug use and mood disorders. Time trends varied slightly over the 5 years. Prevalence rates in real-world settings might be useful for policymakers interested in planning the public mental health system in large Brazilian cities.

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“…In the last few decades, inpatient care has undergone fundamental changes, predominantly driven by deinstitutionalization policy initiatives and greater emphasis on communitybased services (Zeshan et al 2018). Decreasing length of stay is a common policy and practice directive internationally, largely to reduce costs and encourage independent functioning outside of the hospital environment (Baeza et al 2018;Green et al 2007;Zeshan et al 2018). Furthermore, more alternatives are now available within community settings, such as short-term prevention and recovery centres.…”

Section: Introductionmentioning

confidence: 99%

What nonpharmacological therapeutic interventions are provided to adolescents admitted to general mental health inpatient units? A descriptive review

Hayes

Palmer²,

Hamilton

et al. 2019

Int J Mental Health Nurs

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Limited research exists regarding the therapeutic operations of adolescent mental health inpatient units, particularly in terms of nonpharmacological therapeutic interventions. This review collates what is known about reported nonpharmacological therapeutic interventions for young people admitted to general or non‐disorder‐specific adolescent mental health inpatient settings. A descriptive review of this nature was not located in the literature. The aim was to identify what is currently known about reported nonpharmacological therapeutic interventions. The purpose was to consider gaps and contribute to further work being undertaken in describing an exemplary inpatient model of care for adolescents. Sources included CINAHL, MEDLINE, ERIC, EMBASE, and PsycINFO. Studies included were those published in English, between the years 2000 and 2018. Exclusions included residential, community, outpatient, forensic settings, and studies detailing pharmacological interventions. Ten studies were identified. This descriptive review provides an objective foundation to inform an exemplary inpatient model of care currently being investigated. There is a critical need to understand these interventions to identify key components of an inpatient model of care. Such knowledge will provide guidance for future services seeking to create an exemplary model of care. Furthermore, these results can influence current practice by improving quality and delivery of inpatient care.

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Predictors of length of stay in an acute psychiatric inpatient facility in a general hospital: a prospective study

Abstract: Identifying patients who will need to stay longer in psychiatric beds remains a challenge. Improving knowledge about determinants of LOS could lead to improvements in the quality of care in hospital psychiatry.

Cited by 25 publications

References 22 publications

Length of Stay of Psychiatric Admissions: a Case-Control Study

Length of Stay of Psychiatric Admissions: a Case-Control Study

Prevalence and trends of mental disorders requiring inpatient care in the city of Porto Alegre: a citywide study including all inpatient admissions due to mental disorders in the public system from 2013-2017

What nonpharmacological therapeutic interventions are provided to adolescents admitted to general mental health inpatient units? A descriptive review

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