Predictors of the length of stay of psychiatric inpatients: protocol for a systematic review and meta-analysis

Carranza-Navarro, Farid; Alvarez‐Villalobos, Neri Alejandro; Muñoz, Andrea Muriel Contreras; Medrano, Andrea Fernanda Guerrero; Rodríguez, Natalia Sofía Tamayo; Uribe, Erasmo Saucedo

doi:10.1186/s13643-021-01616-6

Cited by 9 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is also important to note that the length of stay of the current sample differs from those that may be evident within other settings globally, with differences noted between public and private psychiatric settings, and across countries. For instance, the maximum reported mean length of stay in the United States in a systematic review of 30 studies was 24.9 days, which matches the current sample (Navarro et al, 2021; Tulloch et al, 2011), while in a review of high-income European nations the average length of stay for hospitalized psychiatric patients was 39.4 days (ranging from 17.9 mean days to 55).…”

Section: Discussionsupporting

confidence: 70%

Daily prediction of inpatient suicide attempts using routinely collected theory-driven data.

Kyron,

Hooke,

Bryan

et al. 2024

Journal of Psychopathology and Clinical Science

View full text Add to dashboard Cite

We lack knowledge about the short-term predictors of suicide attempts (SAs) among treatment-seeking individuals. The current study evaluated whether (a) interpersonal difficulties, hopelessness, and affective states are associated with an increased risk of SAs on the same and the next day; (b) these daily states are interconnected differently over time among inpatients who attempt suicide compared to those who do not. In total, 110 psychiatric inpatients who attempted suicide during their stay at a psychiatric hospital self-reported their suicidal ideation, negative affect, positive affect, wish to live, interpersonal needs, and hopelessness each day (3,018 daily reports). Multilevel structural equation modeling was used to examine same-day and next-day predictors of SAs. Multilevel temporal network models assessed interconnectedness between daily predictors and were compared to network models from a matched sample of 110 psychiatric inpatients who did not attempt suicide. In multivariate models, increases in perceived burdensomeness were significantly associated with same-day SAs, whereas increased hopelessness was associated with next-day SAs. Network models for patients who attempted suicide indicated that hopelessness and suicidal ideation were central to change, leading to nextday deteriorations in mental health. In subsequent models, feeling calm and relaxed, and feeling fresh and rested were centrally connected to other variables. The centrality of these metrics tended to be higher than in the network models for patients who did not attempt suicide, suggesting differences in the interplay between risk and protective factors. This study suggests routinely monitoring interpersonal factors and hopelessness may help identify increased short-term risk of SAs among psychiatric inpatients. General Scientific SummaryDaily fluctuations in cognitive-affective states, such as interpersonal difficulties and hopelessness, may signal short-term risk for suicide attempts beyond reported levels of suicidal ideation. Hopelessness in particular exhibits high interconnectedness with other risk factors, potentially making it an effective target for interventions.

show abstract

Section: Discussionsupporting

confidence: 70%

Daily prediction of inpatient suicide attempts using routinely collected theory-driven data.

Kyron,

Hooke,

Bryan

et al. 2024

Journal of Psychopathology and Clinical Science

View full text Add to dashboard Cite

show abstract

“…According to Navarro et. al (2021) and Dimitri et al . (2018), the average length of stay in Italy was 17.9 days.…”

Section: Introductionmentioning

confidence: 91%

“…The Italian psychiatric system has some peculiarities that need to be described because this system could lead to shorter hospitalization, the shortest in Europe (Navarro et al . 2021), an important factor influencing the ward climate and the ward rules. In Italy, since 1980, patients needing hospitalization because of an acute psychiatric disorder are admitted to acute units called Psychiatric Diagnosis and Care Services (SPDCs) each with a maximum of 16 beds.…”

Section: Introductionmentioning

confidence: 99%

Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions

Corbetta¹,

Corso

Camuccio

2022

Int J Mental Health Nurs

View full text Add to dashboard Cite

The ward climate or atmosphere refers to its material, emotional and social conditions. A good ward climate in psychiatric settings can influence the mood, behaviour and self-concept of patients and staff members and improve patient outcomes. Many studies have examined the relationship between ward climate and aggression, but only a few have investigated the effect of a ward's environment, rules and activities. This multicentric observational study aimed to assess the relationship between the rules/activities and the climate of four acute psychiatric units of Northern Italy. The Essen Climate Evaluation Scheme (EssenCES) questionnaire, which was administered to patients and staff, was used to evaluate the different dimensions of ward atmosphere. There was a good response rate (79%) in patients and staff members who completed the questionnaire (114 patients and 109 staff). Safety perception appeared to be quite different in patients and staff. The patients who were authorized to have more visiting hours and more time to use their mobile phone had higher scores on Experienced Safety subscale. A negative correlation between the Therapeutic Hold and Experienced Safety subscales was found in the staff members, and this was due to their negative perception. The ward climate seemed to be affected by the unit's rules, especially with respect to visits and the smartphones use. Nurses need to be aware of the importance of ward climate and how their own perception may differ from and that of patients: this gap could lead to decisions detached from the patients' needs.

show abstract

“…In addition to readmission rates and frequency of ED visits, length of stay (LOS) is another important quality of care indicator. LOS is defined as the number of days between admission and discharge dates for each admission experienced [ 20 ]. LOS is likely to be multifactorial, but some factors associated with longer LOS have been consistently identified: biological sex (being male), ethnicity (being Asian, Black, or having mixed background), accommodation status (being homeless) and having the primary diagnosis of psychosis.…”

Section: Introductionmentioning

confidence: 99%

Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study

Adu,

da Luz Dias,

Obuobi-Donkor

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

Background Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. In light of this evidence there is a pressing need to provide accessible mental health services in flexible yet cost-effective ways. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative for people in need of mental health care without requiring emergency department visits or hospitalization. This new service is referred to as the Rapid Access and Stabilization Program (RASP). This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners' (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population. Method This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison (pre- and post-evaluation study) will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison (cohort study) will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and health care partners' impressions. Discussion We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days, in both within-subject and between-subject comparisons. In addition, we anticipate that patients, healthcare providers and healthcare partners would express high levels of satisfaction with the new service. Conclusion This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.

show abstract

Predictors of the length of stay of psychiatric inpatients: protocol for a systematic review and meta-analysis

Cited by 9 publications

References 25 publications

Daily prediction of inpatient suicide attempts using routinely collected theory-driven data.

Daily prediction of inpatient suicide attempts using routinely collected theory-driven data.

Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions

Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study

Contact Info

Product

Resources

About