title: Determinants of inpatient psychiatric length of stay in an urban county hospital.
abstract: 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.
authors.affiliation: Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA. mcompto@emory.edu
authors.forename: Michael T
authors.initials: MT
authors.lastname: Compton
authors.forename: Jason
authors.initials: J
authors.lastname: Craw
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Rudisch
mesh_terms: 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