Patient characteristics related to length of stay in Dutch forensic psychiatric care

Abstract

Create an overview of characteristics of patients in long-term forensic psychiatric care (LFPC) with a higher length of stay (LOS) care compared to patients in regular forensic psychiatric care (RFPC) with a shorter LOS. Data were collected from 139 patient records. This study examined whether patients in LFPC differ from patients in RFPC on sociodemographic data, legal data and clinical data and whether those characteristics are able to predict LOS. Patients in LFPC were more often born in a Dutch Caribbean country, less often had a substance abuse disorder, were more often emotionally neglected during childhood, had a higher HCR-20 risk item score, a higher security needs score, a higher (less successful) recovery score, were more often recidivist and had absconded more often than RFPC patients. Certain characteristics were able to distinguish the longer LOS group which might be useful to establish sequel services and enhance treatment efficiency.

Factors And Predictors Of Length Of Stay In Offenders Diagnosed With Schizophrenia- A Machine-learning-based Approach

“…In recent years, prolonged inpatient treatment in psychiatry in general and forensic psychiatry in particular has faced more and more criticism and scientific scrutiny: Especially within involuntary treatment settings, inappropriately long stays have been viewed as potentially unethical (1)(2)(3)(4)(5)(6). In addition, doubts have been raised about the benefits of prolonged inpatient treatment for patients' rehabilitation (3,7). Prolonged duration of inpatient treatment has been discussed as an indicator of economic inefficiency -particularly for forensic inpatient treatment, which constitutes a low-volume high-cost sector (3,(8)(9)(10)(11)(12)(13)(14).…”

“…Prolonged duration of inpatient treatment has been discussed as an indicator of economic inefficiency -particularly for forensic inpatient treatment, which constitutes a low-volume high-cost sector (3,(8)(9)(10)(11)(12)(13)(14). The internationally observed prolongation of forensic hospitalizations in the past years (1,3,7,(15)(16)(17), as well as the ever-growing demand for forensic services (18)(19)(20)(21), have become a subject of socio-political debate with urgent need for more research on avenues to reduce the duration of inpatient treatments in order to reduce exploding costs whenever possible (2,4). A recent review of 38 studies in eleven countries summarized a rich set of patient characteristics contributing to length of stay in psychiatric inpatient treatment (6), but concluded that just ten studies were useful in identifying clinically useful predictive factors, since "more rigorous multivariate statistical techniques" are required in order to eliminate confounding factors.…”

“…With regard to socio-demographic factors, factors correlating with prolonged inpatient treatment included male gender (3,33,34), white skin colour (25,30,34), advanced age at the time of admission (15,28), being unmarried (34,35), low educational qualifications (16,28,(34)(35)(36), low IQ (35), adjustment, socialisation, and partnership issues (36), no discharge address (15), unemployment before admission (16,28,(35)(36)(37), and having lived with ones parents before admission (16). There is also some evidence that emotional neglect during childhood has a prolonging effect (7). Socio-demographic variables associated with a reduction of time spent in inpatient treatment included being a parent (1), good contact with one's family or good social support (26)(27)(28), and living in a close relationship (16).…”

“…Socio-demographic variables associated with a reduction of time spent in inpatient treatment included being a parent (1), good contact with one's family or good social support (26)(27)(28), and living in a close relationship (16). While some studies reported prolonged inpatient treatment for certain religious minorities (28) and patients having migrated (7), others reported shorter length of stay for immigrants (16) and ethnic minorities (17).…”

“…hospitalized for a prolonged period of time to be more likely to have engaged in past criminal and violent behaviours (3,26,35) and to be of younger age at their first delinquency or violent incident (3,16,35). Patients who had been admitted to a (forensic) psychiatric institution before or had been younger at their first psychiatric contact also tended to hospitalized longer (1,7,16,17,31,34,38).…”