Determinants of Inpatient Psychiatric Length of Stay in an Urban County Hospital

Compton, Michael T.; Craw, Jason; Rudisch, Bruce

doi:10.1007/s11126-006-9005-z

Cited by 60 publications

(67 citation statements)

References 23 publications

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“…Longer hospital stays can be related not only to the severity of the mental disorder but also to non-clinical factors such as the severity of psychosocial stressors, unemployment, and inadequate financial and social resources. [31][32][33][34][35] Hospitalizations in traditional psychiatric hospitals are expected to last approximately 20 days, while in general hospitals their duration is expected to be shorter than those observed in this study. 36,37 Again, this can be attributed to the organization of the local network, since usually one of the hospital's wards at the general hospital is in charge of highly complex cases.…”

Section: Discussionmentioning

confidence: 99%

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Barros

Marques

Carlotti

et al. 2009

Rev. Bras. Psiquiatr.

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Objective: Characterize and compare acute psychiatric admissions to the psychiatric wards of a general hospital (22 beds), a psychiatric hospital (80) and of an emergency psychiatry unit (6). Method: Survey of the ratios and shares of the demographic, diagnostic and hospitalization variables involved in all acute admissions registered in a catchment area in Brazil between 1998 and 2004. Results: From the 11,208 admissions, 47.8% of the patients were admitted to a psychiatric hospital and 14.1% to a general hospital. The emergency psychiatry unit accounted for 38.1% of all admissions during the period, with a higher variability in occupancy rate and bed turnover during the years. Around 80% of the hospital stays lasted less than 20 days and in almost half of these cases, patients were discharged in 2 days. Although the total number of admissions remained stable during the years, in 2004, a 30% increase was seen compared to 2003. In 2004, bed turnover and occupancy rate at the emergency psychiatry unit increased. Conclusion:The increase in the number of psychiatric admissions in 2004 could be attributed to a lack of new community-based services available in the area beginning in 1998. Changes in the health care network did affect the emergency psychiatric service and the limitations of the community-based network could influence the rate of psychiatric admissions. Descriptors

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Section: Discussionmentioning

confidence: 99%

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Barros

Marques

Carlotti

et al. 2009

Rev. Bras. Psiquiatr.

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“…Subjectively rated variables (e.g., treatment plan adherence during hospitalization, the treatment team’s opinion of likelihood of follow-up) were obtained by consulting with the social worker, the psychiatry resident or psychology intern, and the attending psychiatrist caring for the patient during hospitalization. As described in two recently published reports, basic demographic, socioeconomic, psychosocial, and clinical data were recorded in a systematic fashion using a standardized data collection instrument [17, 18]. The criterion variable of interest in this analysis was a three-level variable representing the patient’s legal status at admission and at discharge: VOL-VOL, INV-VOL, and INV-INV.…”

Section: Methodsmentioning

confidence: 99%

Characteristics associated with involuntary versus voluntary legal status at admission and discharge among psychiatric inpatients

Craw

Compton

2006

Soc Psychiat Epidemiol

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j Abstract Background The objective of this analysis was to determine the ways in which patients' legal statuses at hospital admission and discharge are associated with select sociodemographic and clinical variables. This study specifically investigated differences between patients who were voluntary during both admission and discharge, patients who were involuntary on admission but voluntary on discharge (having converted to voluntary status during hospitalization), and patients who were involuntary during both admission and discharge. Method Data were collected from the charts and treating clinicians of 227 consecutively discharged patients from two psychiatric units in a large, urban, county hospital in the southeastern United States. Based on results of bivariate tests, sociodemographic and clinical factors were entered into a polytomous logistic regression model to determine effect estimates (adjusted odds ratios). Results In the bivariate analyses, 15 variables were significantly associated with the trichotomous legal status. In the model, three factors were independently significantly associated with legal status, while controlling for four potential confounders: (1) whether or not the patient was experiencing psychotic symptoms at discharge, (2) whether or not the patient had documented medical problems requiring medication at discharge, and (3) the number of psychiatric medications. Conclusions A generalized lack of treatment engagement and adherence among involuntary patients likely underlies significant differences between the groups in terms of psychotic symptoms, diagnosed medical problems requiring medications, and number of psychiatric medications at discharge. Studying legal status (and the process of legal status conversion from involuntary to voluntary) and its correlates is an important topic for further research.

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“…This is especially important as administrators, payers and health service researchers are increasingly interested in length of stay as an indicator of the quality and efficiency of inpatient psychiatric hospitalization (Blais et al, 2003; Compton, Craw, & Rudisch, 2006). Both studies investigated variables related to length of stay including the GAF.…”

Section: New Measure Of Overall Functioningmentioning

confidence: 99%

Assessing Overall Functioning With Adolescent Inpatients

Haggerty¹,

Forlenza²,

Poland³

et al. 2014

Journal of Nervous &Amp; Mental Disease

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The current study looks to evaluate the validity and reliability of a brief measure of overall functioning for adolescents. Clinicians were asked to complete the Overall Functioning Scale for 72 adolescents consecutively admitted to the adolescent psychiatric inpatient service of a community safety net medical center. The results revealed that this new measure is related to the patients’ length of stay, clinician-rated measures of social cognition and object relations, Global Assessment of Functioning score at admission, and global rating of engagement in individual psychotherapy. Results also showed that the OFS was related to patients’ history of non-suicidal self-harm as well as treatment outcome as assessed by measures of psychological health and well-being and symtomatology. Hierarchical regressions reveal that the OFS shows incremental validity above the admission GAF score in predicting length of stay. The results also showed that the OFS demonstrates inter-rater reliability in the excellent range (ICC 1,2) of .88. Clinical implications of the use of this tool as well as areas of future research are discussed.

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Determinants of Inpatient Psychiatric Length of Stay in an Urban County Hospital

Cited by 60 publications

References 23 publications

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Characteristics associated with involuntary versus voluntary legal status at admission and discharge among psychiatric inpatients

Assessing Overall Functioning With Adolescent Inpatients

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