Brief Hospital Treatment of Schizophrenia—Early Results of a Multiple - Hospital Study

Caffey, Eugene M.; Jones, Robert; Diamond, Leon S.; Burton, Eleanor; Bowen, William T.

doi:10.1176/ps.19.9.282

Cited by 12 publications

(2 citation statements)

References 2 publications

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“…Two excluded studies used quasi-randomisation techniques. Caffey 1968, assigned in rotation to one of three groups, and Rosen 1976, ’assigned on a first come first served basis according to date of application and availability of beds’.…”

Section: Resultsmentioning

confidence: 99%

Length of hospitalisation for people with severe mental illness

Alwan¹,

Johnstone²,

Zolese³

2008

Cochrane Database of Systematic Reviews

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Background In high income countries, over the last three decades, the length of hospital stays for people with serious mental illness has reduced drastically. Some argue that this reduction has led to revolving door admissions and worsening mental health outcomes despite apparent cost savings, whilst others suggest longer stays may be more harmful by institutionalising people to hospital care. Objectives To determine the clinical and service outcomes of planned short stay admission policies versus a long or standard stay for people with serious mental illnesses. Search methods We searched the Cochrane Schizophrenia Group’s register of trials (July 2007). Selection criteria We included all randomised trials comparing planned short with long/standard hospital stays for people with serious mental illnesses. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a fixed effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated fixed effects weighted mean differences (WMD). Main results We included six relevant trials. We found no significant difference in hospital readmissions between planned short stays and standard care at one year (n=651, 4 RCTs, RR 1.26 CI 1.0 to 1.6). Short hospital stay did not confer any benefit in terms of ’loss to follow up compared with standard care (n=453, 3 RCTs, RR 0.87 CI 0.7 to 1.1). There were no significant differences for the outcome of ’leaving hospital prematurely’ (n=229, 2 RCTs, RR 0.77 CI 0.3 to 1.8). More post-discharge day care was given to participants in the short stay group (n=247, 1 RCT, RR 4.52 CI 2.7 to 7.5, NNH 3 CI 2 to 6) and people from the short stay groups were more likely to be employed at two years (n=330, 2 RCTs, RR 0.61 CI 0.5 to 0.8, NNT 5 CI 4 to 8). Economic data were few but, once discharged, costs may be more for those allocated to an initial short stay. Authors’ conclusions The effects of hospital care and the length of stay is important for mental health policy. We found limited data, although outcomes do suggest that a planned short stay policy does not encourage a ’revolving door’ pattern of admission and disjointed care for people with serious mental illness. More large, well-designed and reported trials are justified.

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Section: Resultsmentioning

confidence: 99%

Length of hospitalisation for people with severe mental illness

Alwan¹,

Johnstone²,

Zolese³

2008

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

“…In a study conducted in the United Kingdom, the efficiency of an average of 9 days of hospitalization time was compared to a period of 14 days 4 . The common result of all studies indicates that the improvement in symptoms during long-term hospitalizations is not superior to that of shortterm hospitalizations in terms of social adaptation and the time it takes the patient to return to the hospital [5][6][7][8][9][10][11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%