A Review of Issues Surrounding Length of Psychiatric Hospitalization

Casemix funding in psychiatry:Some problems and common pitfalls

“…In psychiatry, however, it is difficult for these premises to be met. There is increasing evidence of considerable variability in resource requirements of psychiatric patients who fall within the same DRG (Caton & Gralnick 1987;Schumacher et al 1986;McGuire & Bender 1994;Faulkner, Tobin & Weir 1994;Mitchell et al 1987;English et al 1986). …”

A field trial using Artificial Neural Networks to predict psychiatric in-patient Length-of-stay

“…Randomizing the data set across the three-andone-half-year period (1988-1991) was done to control such factors as policy changes, economic conditions, and resource availability which are known to contribute to variations in LOS [6]. The test sets are run through the trained ANN and LOS predictions are made for each case in the test sets.…”

“…Unlike general medicine, predicting Length-Of-Stay (LOS) in complex psychiatric disorders is difficult, because factors related to LOS are weakly associated or not known [1]. Researchers have expended considerable effort in predicting inpatient LOS for psychiatric patients; however, they have been unable to accurately codify this process using classical statistical analysis [2][3][4][5][6]. As a result, decision support tools to augment diagnosis and treatment are limited and, without these tools, the ability to effectively manage resources is subject to the vagaries of inexperience, system failure, including changing policies, inequities in resources and poor communication.…”

Facilitating effective residency education on short-term inpatient units

“…(1,9,10) Canton and Gralinick (1987) have reviewed the growing empirical evidence suggesting that brief inpatient treatment is effective for many patients. (14) These findings combined with increasing economic pressures have caused teaching services, even those well known for robustly resisting change, to move to decrease length of stay and find new ways to meet the important educational objectives of the inpatient training experience.…”