Differences between long-stay and short-stay inpatients and estimation of length of stay

Jakubaschk, J; Waldvogel, Doris; Würmle, Othmar

doi:10.1007/bf00802097

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…Our results are consistent with recent findings that, with respect to short-term hospitalization, diagnosis is not the most relevant factor in determining the length of stay (9)(10)(11) or relapse (13). Rather, growing evidence points to severity of illness and the number or duration of previous hospitalizations (9,(11)(12)(13) and specific psychiatric symptoms, notably negative symptoms such as blunted affect and emotional withdrawal, as well as self-neglect and thought disorder (9,13,35) as more relevant predictors of long-term outcome.…”

Section: Discussionsupporting

confidence: 95%

See 1 more Smart Citation

Relationship Between Diagnosis and Disposition of Patients Admitted to a State Psychiatric Hospital

Advokat

Eustis²,

Pickering³

2005

Psychiatr Q

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The lifetime outcome for individuals diagnosed with affective disorders is generally more favorable than for those diagnosed with a schizophrenic disorder. We determined if a similar differential outcome could be detected among 139 patients hospitalized on the admissions unit of a state psychiatric facility between 1998 and 2001, and diagnosed with a Schizophrenic, Schizoaffective or Affective Disorder. The placement of each patient on discharge was categorized as an outpatient environment, a minimum-security treatment unit, a locked ward, or a highly secure forensic facility. Patients with an affective disorder were significantly less likely than the other two groups to have a co-occurring diagnosis of substance abuse, and they performed better on the neuropsychological assessments. However, the groups did not differ in their discharge placements, or in their length of stay. These findings suggest that resolution of more acute symptomatology may be unrelated to factors associated with long-term outcome for individuals suffering from severe and persistent mental illness.

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Section: Discussionsupporting

confidence: 95%

“…Rather, growing evidence points to severity of illness and the number or duration of previous hospitalizations (9,(11)(12)(13) and specific psychiatric symptoms, notably negative symptoms such as blunted affect and emotional withdrawal, as well as self-neglect and thought disorder (9,13,35) as more relevant predictors of long-term outcome.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Diagnosis and Disposition of Patients Admitted to a State Psychiatric Hospital

Advokat

Eustis²,

Pickering³

2005

Psychiatr Q

View full text Add to dashboard Cite

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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: 99%

“…Studies of psychiatric inpatient length of stay among mixed age populations generally find that medical co-morbidity, (1,(6)(7)(8) prior hospitalization (9)(10)(11)(12)(13), and use of electroconvulsive therapy (11,(14)(15)(16)(17)(18)(19) increase LOS. 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.…”

Section: Introductionmentioning

confidence: 99%

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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“…While these individuals may still require a significantly longer LOS, this interval might be reduced if they were administered SGAs on admission, rather than being switched to one after a failed FGA trial. Identification of a common characteristic associated with the switch, such as more severe symptomatology or a particular type or group of symptoms, might improve the cost-effectiveness of these agents [25][26][27][28]. A similar argument might be applied to the issue of antipsychotic polypharmacy.…”

Section: Discussionmentioning

confidence: 94%

‘Real World’ Comparison of First- and Second-Generation Antipsychotics in Regard to Length of Inpatient Hospitalization and Number of Re-hospitalizations

2007

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The purpose of this study was to determine if Second-Generation Antipsychotics (SGAs), relative to First-Generation Antipsychotics (FGAs), reduced either the length of stay (LOS) or number of re-hospitalizations of schizophrenic patients receiving treatment in a state psychiatric hospital. Medical records were compared for the periods 1991-1994 and 2001-2004 for three inpatient groups: those receiving FGAs, those receiving SGAs, and those switched from FGAs to SGAs. During both time periods, patients on FGAs had significantly shorter LOS than either those receiving SGAs or those switched from FGAs to SGAs. Therefore, inpatients receiving SGAs were hospitalized longer than those receiving FGAs. Conversely, once discharged, patients receiving SGAs were significantly less likely to be re-admitted than patients discharged on FGAs. The data suggest that some patients do benefit from SGAs and it may be cost-effective in the long-term, to determine when to utilize FGAs first and when to switch from the older to the newer agents.

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Differences between long-stay and short-stay inpatients and estimation of length of stay

Cited by 20 publications

References 11 publications

Relationship Between Diagnosis and Disposition of Patients Admitted to a State Psychiatric Hospital

Relationship Between Diagnosis and Disposition of Patients Admitted to a State Psychiatric Hospital

Determinants of Geropsychiatric Inpatient Length of Stay

‘Real World’ Comparison of First- and Second-Generation Antipsychotics in Regard to Length of Inpatient Hospitalization and Number of Re-hospitalizations

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