Determinants of inpatient psychiatric length of stay in an urban county hospital.
This study investigated predictors of length of stay (LOS) for two inpatient psychiatric units (a crisis stabilization unit and a longer-stay milieu unit) in a large, urban, university-affiliated, county hospital. It was hypothesized that three variables would be independently associated with shorter LOS: (1) higher Global Assessment of Functioning (GAF) scale scores, (2) not requiring the use of seclusion or restraints, and (3) the presence of a comorbid substance use disorder. Data were collected on consecutive discharges (n=234) from the two inpatient units. Bivariate tests were conducted, and multiple linear regression models assessed the independent effects of potential determinants of LOS. The presence of a comorbid personality disorder or substance use disorder was predictive of shorter LOS on the crisis stabilization unit (n=88). Several variables were found to be predictive of shorter LOS on the longer-stay milieu unit (n=146), including: involuntary legal status on discharge, not requiring seclusion or restraints, higher admission GAF scale score, female gender, and the presence of a comorbid substance use disorder. Findings indicate that a substantial portion of the variance in LOS in this setting can be predicted from basic sociodemographic and clinical factors available in hospital medical charts.
Compton
Michael T
MT
Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA. mcompto@emory.edu
Craw
Jason
J
Rudisch
Bruce E
BE
D000328:Adult; D005260:Female; D005845:Georgia; D006757:Hospital Units; D006766:Hospitals, County / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000145:classification / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D012959:Socioeconomic Factors