The Nordic Comparative Study on Sectorized Psychiatry–length of in‐patient stay

Øiesvold, Terje; Saarento, O; Sytema, Sjoerd; Christiansen, Lene; Göstas, G; Lönnerberg, O; Muus, S; Sandlund, Mikael; Hansson, Lars

doi:10.1111/j.1600-0447.1999.tb10849.x

Cited by 31 publications

(25 citation statements)

References 35 publications

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“…Other research also has demonstrated that the presence of a personality disorder diagnosis may be associated with a shorter LOS (11,13). Also consistent with previous research (14), the absence of psychosis was predictive of shorter LOS, though the effect of this variable failed to reach statistical significance when adjusting for the other variables in the models for both units.…”

Section: Discussionsupporting

confidence: 80%

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

2006

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This study investigated predictors of length of stay (LOS) for two inpatient psychiatric units (a crisis stabilization unit and a longer-stay milieu unit) in a large, urban, university-affiliated, county hospital. It was hypothesized that three variables would be independently associated with shorter LOS: (1) higher Global Assessment of Functioning (GAF) scale scores, (2) not requiring the use of seclusion or restraints, and (3) the presence of a comorbid substance use disorder. Data were collected on consecutive discharges (n=234) from the two inpatient units. Bivariate tests were conducted, and multiple linear regression models assessed the independent effects of potential determinants of LOS. The presence of a comorbid personality disorder or substance use disorder was predictive of shorter LOS on the crisis stabilization unit (n=88). Several variables were found to be predictive of shorter LOS on the longer-stay milieu unit (n=146), including: involuntary legal status on discharge, not requiring seclusion or restraints, higher admission GAF scale score, female gender, and the presence of a comorbid substance use disorder. Findings indicate that a substantial portion of the variance in LOS in this setting can be predicted from basic sociodemographic and clinical factors available in hospital medical charts.

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Section: Discussionsupporting

confidence: 80%

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

2006

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“…Age and gender relationship to psychiatric LOS have been reported in several studies [9,12,14,16,21]. Oiesvold et al [14] report longer LOS for patients in the older ages and for females in psychiatric patients in hospitals of Sweden and Finland.…”

Section: Discussionmentioning

confidence: 97%

Observed-predicted length of stay for an acute psychiatric department, as an indicator of inpatient care inefficiencies. Retrospective case-series study.

Jiménez

Lam

Marot

et al. 2004

BMC Health Serv Res

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Background: Length of stay (LOS) is an important indicator of efficiency for inpatient care but it does not achieve an adequate performance if it is not adjusted for the case mix of the patients hospitalized during the period considered. After two similar studies for Internal Medicine and Surgery respectively, the aims of the present study were to search for Length of Stay (LOS) predictors in an acute psychiatric department and to assess the performance of the difference: observed-predicted length of stay, as an indicator of inpatient care inefficiencies.

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“…Inconsistent correlations with length of stay have been noted for key demographic characteristics; (1,(20)(21)(22)(23) age, gender and marital status are found to be both good (9,(24)(25)(26)(27)(28)(29)(30)(31)(32) and poor (1,14,(20)(21)(22)27,33,34) predictors of LOS. Interestingly, psychiatric diagnosis without some measure of severity and the diagnostic related groups (DRGs) used for Medicare reimbursement are also unpersuasive as predictors of LOS with as many studies finding them related to LOS (2,(5)(6)(7)17,21,22,24) as not (3,(9)(10)(11)(12)18,(35)(36)(37)(38)(39).…”

Section: Introductionmentioning

confidence: 85%

Determinants of Geropsychiatric Inpatient Length of Stay

et al. 2005

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Despite efforts to decrease lengths of acute psychiatric hospital stays, some geriatric inpatients continue to have extended stays. This research examined factors related to length of stay (LOS), including legal and administrative factors not traditionally included in prior studies. The charts of 384 patients, representing all 464 discharges from an inpatient geropsychiatric unit over a one-year period, were evaluated retrospectively and analyzed using logistic regression and logarithmic transformation. The LOS of over 12% of the inpatients was 26 days or more (average LOS 14.1). Factors significantly associated with longer LOS were: receiving electroconvulsive therapy (ECT), higher Brief Psychiatric Rating Scale (BPRS) positive symptoms scores, falling, pharmacology complications, multiple prior psychiatric hospitalizations, requiring court proceedings to continue hospitalization or medicate against will, consultation delays and not performing ECT on weekends. Neither demographics nor diagnoses alone had influence on length of stay. Incorporation of LOS predictors into Medicare Inpatient Prospective Payment System (IPPS) would more accurately account for the complexity in the cost of caring for geropsychiatry patients.

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The Nordic Comparative Study on Sectorized Psychiatry–length of in‐patient stay

Abstract: Stratifying on gender, diagnostic group and hospital revealed a general pattern of associations except for age.

Cited by 31 publications

References 35 publications

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

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

Observed-predicted length of stay for an acute psychiatric department, as an indicator of inpatient care inefficiencies. Retrospective case-series study.

Determinants of Geropsychiatric Inpatient Length of Stay

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