Characteristics of short-stay admissions to a psychiatric inpatient service.
Since the rapid expansion of managed care coupled with dramatic reductions in lengths of inpatient stay, there is widespread concern that the emphasis on cost containment is eclipsing attention to patient care. The present study was undertaken to evaluate speculations that the majority of short-stay (less than 48 hours) admissions to a psychiatric inpatient service at a large teaching hospital in the midwestern United States consisted of public pay patients who were rapidly transferred to area state hospitals. Using two cases mix measures, severity of illness and changes in acuity and clinical outcomes of a sample of short-stay (n = 77) and longer stay (n = 145) admissions were compared. Short-stay admissions, although similar to longer stay patients in terms of demographics, Axis I diagnosis, payer status, and appropriateness of admission, are clinically distinct. The use of nonhospital alternatives in treating a subsample of suicidal patients and the implications for improved mental health services delivery are discussed.
Yohanna
D
D
Northwestern University Medical School, Chicago, IL 60611, USA. dyohanna@nmh.nwu.edu
Christopher
N J
NJ
Lyons
J S
JS
Miller
S I
SI
Slomowitz
M
M
Bultema
J K
JK
D000328:Adult; D003419:Crisis Intervention / Q000592:standards; D003953:Diagnosis-Related Groups; D005260:Female; D006302:Health Services Research; D006783:Hospitals, State; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015146:Midwestern United States; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data*; D018579:Patient Selection; D010360:Patient Transfer; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012720:Severity of Illness Index