Stationäre psychiatrische Behandlungsdauer

Kluge, H.; Hülsmann, S.; Kopf, A.; Angermeyer, M. C.; Becker, T.

doi:10.1055/s-2002-34441

Cited by 1 publication

(2 citation statements)

References 5 publications

(10 reference statements)

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“…Other clinical variables besides psychopathology such as substance abuse or severity of illness at admission had a minor influence on the length of stay as well, which is in line with previous findings taking several hospitals in a whole catchment area into account while controlling for the factor "hospital" [11]. According to a previous study [21,23], the consideration of variables related to treatment within hospital stay led to an explained variation of more than 20%.…”

Section: Discussionsupporting

confidence: 85%

“…Variables that significantly increased the amount of explained variation or that were considered to be important determinants of LOS were for instance: type of admission [9], comorbidity, severity of illness [22] or level of functioning [22]. The amount of explained variation in LOS attained more than 20% in studies considering process-oriented variables like complications during hospitalisation and treatment factors [21,23]. …”

Section: Introductionmentioning

confidence: 99%

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Does psychopathology at admission predict the length of inpatient stay in psychiatry? Implications for financing psychiatric services

2011

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BackgroundThe debate on appropriate financing systems in inpatient psychiatry is ongoing. In this context, it is important to control resource use in terms of length of stay (LOS), which is the most costly factor in inpatient care and the one that can be influenced most easily. Previous studies have shown that psychiatric diagnoses provide only limited justification for explaining variation in LOS, and it has been suggested that measures such as psychopathology might be more appropriate to predict resource use. Therefore, we investigated the relationship between LOS and psychopathological syndromes or symptoms at admission as well as other characteristics such as sociodemographic and clinical variables.MethodsWe considered routine medical data of patients admitted to the Psychiatric University Hospital Zurich in the years 2008 and 2009. Complete data on psychopathology at hospital admission were available in 3,220 inpatient episodes. A subsample of 2,939 inpatient episodes was considered in final statistical models, including psychopathology as well as complete datasets of further measures (e.g. sociodemographic, clinical, treatment-related and psychosocial variables). We used multivariate linear as well as logistic regression analysis with forward selection procedure to determine the predictors of LOS.ResultsAll but two syndrome scores (mania, hostility) were positively related to the length of stay. Final statistical models showed that syndromes or symptoms explained about 5% of the variation in length of stay. The inclusion of syndromes or symptoms as well as basic treatment variables and other factors led to an explained variation of up to 25%.ConclusionsPsychopathological syndromes and symptoms at admission and further characteristics only explained a small proportion of the length of inpatient stay. Thus, according to our sample, psychopathology might not be suitable as a primary indicator for estimating LOS and contingent costs. This might be considered in the development of future costing systems in psychiatry.

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Section: Discussionsupporting

confidence: 85%