[Outcome predictors of intermediate-term treatments in inpatient child and adolescent psychiatry].
Purpose of this study is to identify predictors of the length of stay (LOS) in child and adolescent psychiatry (CAP) and the success of inpatient treatment. All child and adolescent inpatients that had been dismissed over a year's time from a non-university hospital after a medium-length-treatment were rated by their therapists (crisis interventions for < 2 weeks excluded). The group featured a low drop-out-rate (9.8%) and a high percentage of "problematic patients". The ICD-10 diagnoses were irrelevant for the prediction of LOS and success of treatment. The Global Assessment of Function scale (axis VI) correlated significantly with LOS, and functioning in all areas improved with a longer LOS. By the degree of initial psychopathology therapeutic success as well as LOS could be predicted fairly well. Concerning adolescents, motivation for treatment and the degree of cooperation both correlated with LOS and improvement, which implies the importance of their participation. For children under 12, cumulated psychosocial adversities (axis V) predicted a less positive outcome, cooperation of parents and patients raised the chance of success. Shortened lengths of stay will not lead to comparable success. As a system like DRGs for reimbursement of hospitalization in CAP will not prove to be efficient, other variables deserve more attention in future health economy planning. More intervening variables, such as psychosocial adversities, motivation, and cooperation have to be considered.
Schepker
R
R
Westfälisches Institut für Kinder- und Jugendpsychiatrie, Psychotherapie und Heilpädagogik Hamm, Heithofer Allee 64, 59071 Hamm.
Wirtz
M
M
Jahn
K
K
D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission; D010552:Personality Assessment; D011613:Psychotherapy; D012917:Social Adjustment