<p>Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward</p>

Abstract

To evaluate the longest hospitalizations in an acute psychiatric ward [Service of Psychiatric Diagnosis and Treatment (SPDT)] and the related demographic, clinical and organizational variables to understand the factors that contribute to long-stay (LOS) phenomenon. The term "long stay" indicates clinical, social and organizational problems responsible for delayed discharges. In psychiatry, clinical severity, social dysfunction and/ or health-care system organization appear relevant factors in prolonging stays. Patients and Methods: We divided all the SPDT hospitalizations from 1 January 2010 to 31 December 2015 into two groups based on the 97.5 th percentile of duration: ≤36 day (n=3254) and >36 day (n=81) stays, in order to compare the two groups for the selected variables. Comparisons were made using Pearson's chi-square for categorical data and t-test for continuous variables, the correlation between the LOS, as a dependent variable, and the selected variables was analyzed in stepwise multiple linear regression and in multiple logistic regression models. Results: The longest hospitalizations were significantly related to the diagnosis of "schizophrenia and other psychosis" (Pearson Chi 2 =17.24; p=0.045), the presence of moderate and severe aggressiveness (Pearson chi 2 =29; p=0.000), compulsory treatment (Pearson Chi 2 =8.05; p=0.005), parenteral or other route administration of psycho-pharmacotherapy (Pearson Chi 2 =12.91; p=0.007), poli-therapy (Pearson Chi 2 =6.40; p=0.041), complex psychiatric activities (Pearson Chi 2 =12.26; p=0.002) and rehabilitative programs (Pearson Chi 2 =37.05; p=0.000) during the hospitalization and at discharge (Pearson Chi 2 =29.89; p=0.000). Many demographic and clinical variables were statistically significantly correlated to the LOS at our multiple linear and logistic regression model. Conclusion: In our sample, clinical illness severity and need for complex therapeutic and rehabilitative treatments were associated with prolonged psychiatric hospitalizations. Understanding this phenomenon can have not only economic but also clinical, ethical and social relevance.

The impact of implementing a psychiatric emergency hotline on the reduction of acute hospitalizations in a Swiss tertiary hospital

“…Another explanation for the lack of effect of diagnosis may be related to the fact that training of inpatient psychiatrists and the referring private practitioners is very similar, thus resulting in a similar evaluation of the clinical aspects of the case. However, these results are in contrast with the international literature which has shown that the severity of a psychiatric illness is positively correlated with an increase in hospitalizations rates and the length of stay in hospital [ 39 , 40 ]. Other factors also influence the increase in hospitalizations rates, such as socio-demographic characteristics of individuals (e.g., living alone and being unemployed) [ 41 ].…”

A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

“…In the literature, there are many studies aimed at identifying the variables related to psychopathology and psychiatric hospitalization [ 47 , 48 , 49 ], in our study we specifically investigated various factors related to the duration of psychiatric hospitalizations during child development. For this reason, we analyzed possible correlations with the length of stay.…”

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

“…Generalization from adjacent fields also appears problematic as grounds for service development, since FMHS differ in clinical practice (24,25), patient treatment needs (26), and patient characteristics (27,28). Length of compulsory inpatient care is also much longer for FMHS patients (29)(30)(31) than for patients in non-forensic services (32,33). Furthermore, the care objectives in FMHS differ from adjacent service providers given its greater emphasis on the dual task of treating mental disorders and rehabilitating functioning as well as managing risks to others and to society at large (34,35).…”