We evaluated psychiatric care in terms of relationships between patient characteristics and a comprehensive measurement of psychiatric outcomes among inpatients with lengths of stay (LOSs) of 90 days or fewer in a psychiatric hospital in Japan. The sample consisted of inpatients discharged from an acute care psychiatric hospital between September 1 and December 31, 2007. Multivariate analyses were performed to identify patient characteristics related to the outcome of acute psychiatric care. The type of admission was related to difference in Global Assessment of Functioning (GAF) scores (P < 0.001), health care cost (P < 0.001), length of time spent in seclusion (P < 0.001), and length of time spent in restraints (P < 0.01). Diagnosis showed a minimal or non-existent relationship to the outcome variables. The GAF scores of involuntary patients with initially low scores on this axis were greatly improved at discharge. Patients who were admitted involuntarily received more coercive interventions and treatments, such as seclusion and restraints, than did patients with who were admitted voluntarily. Diagnostic groups did not differ in terms of GAF scores. Further studies utilizing diagnostic procedure combination (DPC) data from multiple medical institutions are necessary to verify the present findings.

We evaluated psychiatric care in terms of the relationship between patient outcome (length of stay, Global Assessment of Functioning (GAF) at discharge, GAF difference, and GAF change per day) and psychiatrist characteristics (gender and years in psychiatric practice) in patients with schizophrenia, schizotypal, or delusional disorders (ICD-10 codes F20-F29) and in those with mood disorders (ICD-10 codes F30-F39). The sample consisted of inpatients discharged from an institute in Japan between April 2007 and March 2008. Multivariate analyses were performed to identify patient and psychiatrist characteristics related to outcome. We found that psychiatrist characteristics, such as gender and years in practice, were associated with GAF-related outcomes in patients in the F20-F29 and F30-F39 code groups (P < 0.05, P < 0.001, respectively). Patient characteristics and clinical factors such as GAF at admission, ward type, arrival by ambulance, admission type, seclusion, restraint, diagnosis, and patient age, were associated with outcome in both diagnostic groups. These findings show that gender and years in psychiatric practice had a significant effect on psychiatric patient outcome. Further studies in multiple institutes using a follow-up design are necessary to verify these findings.