Effects of Treatment and Alternative Care on Length of Stay on a General Hospital Psychiatric Unit — Results of an Audit

Abstract

Quality controls are becoming an important part of our health care system. A medical audit is one way of evaluating quality of care, and this paper describes the results of an audit conducted to investigate the reasons for a prolonged stay on a psychiatric inpatient unit. The results showed a decrease in the mean length of stay over a five year period, although the figure remained substantially above provincial norms. A review of the hospital charts of a random sample of one in six patients whose hospital stay exceeded 30 days was carried out. It revealed that in 50.0% of cases the reasons were "medically acceptable," in 10.3% the reasons were "medically unacceptable" and in 39.7% the reasons were "social and administrative" and beyond the control of the treating psychiatrist. The implication of these results are discussed.

Correlates of Length of Admission among Patients Discharged in a Mono-specialist Neuropsychiatric Hospital in Nigeria

“…This is similar to previous studies [7,[14][15][16][17][18] which also observed that these disorders were associated with a longer hospital stay. Master et al explained that this group of disorders are chronic and debilitating, often requiring a longer time for resolution of symptoms and special forms of treatment such as drug dependence treatment and rehabilitation in therapeutic communities [14].…”

“…This was in tandem with previous studies on LOS [14][15][16][17]. These variables are often associated with a worsening symptom severity [16,17].…”

“…These variables are often associated with a worsening symptom severity [16,17]. Multiple episodes and long duration of untreated illness are usually associated with poor response to medication which may be related to the illness process, poor compliance or development of resistance to medications initially used to manage the illness [14,15].…”

Serviços de emergência psiquiátrica e suas relações com a rede de saúde mental Brasileira

“…44 The shortage of beds in psychiatric hospitals and the resulting lack of vacancies for psychiatric hospitalization 45 cause PESs that support PHUGH to be overloaded by cases with comorbid clinical conditions, which demand longer hospitalization periods. 46 In larger metropolitan areas, following the increasing demand of emergencies in other clinical and surgical specialties, PESs end up functioning as hospital units as they maintain patients hospitalized for longer periods. 47 …”

A Canadian Medical-Psychiatric Inpatient Service*

“…Statistics on length of hospital stay are important in planning health care services (12). Most studies have found that patients diagnosed with comorbid psychiatric and medical disorders stay in hospital longer than inpatients with either a psychiatric or medical diagnosis (13).…”