[Prognostic predictors in medium-term inpatient treatment in longitudinal assessment--is there a lower limit for inpatient length of stay?].
A predictor for the individual length of stay (ILOS) was stable for 3 consecutive cohorts of annual inpatient admissions (n = 1.230, excluding drop-outs, crisis interventions for 14 days and less, longterm treatment for 250 days and more), in spite of decreasing average length of stay (ALOS). The predictor consists of CASCAP psychopathology variables, motivational and social functioning variables assessed by the therapist. ICD-10-diagnoses had no influence on ILOS. Improvement on MAS axis VI needed longer average LOS than improvement in symptoms. Unchanged patients had shorter LOS than improved ones, the lower limit of effective LOS being more than about 55 days for improvement of symptoms. Due to our findings, DRGs are not an adequate instrument to determine reimbursement of inpatient treatment in child and adolescent psychiatry.
Schepker
Renate
R
Westfälisches Institut für Kinder- und Jugendpsychiatrie, Psychotherapie und Heilpädagogik Hamm, Heithofer Allee 64, 59071 Hamm. westf.institut.hamm@wkp-lwl.org
Grabbe
Yvonne
Y
Jahn
Karen
K
D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D015331:Cohort Studies; D003419:Crisis Intervention / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D010043:Outcome and Process Assessment, Health Care; D011379:Prognosis; D011613:Psychotherapy / Q000706:statistics & numerical data*; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention