Determinants of length of stay for psychiatric inpatients: analysis of a national database covering the entire Korean elderly population.
OBJECTIVE
In a rapidly aging society, inappropriately long geropsychiatric inpatient hospitalization is a challenging concern for mental health policy-makers and researchers. This study aimed to investigate patient and institutional factors affecting geropsychiatric inpatient length of stay (LOS), providing an overview of current geropsychiatric health care system in South Korea.


METHODS
This retrospective, population-based, cross-sectional study analysed nationwide reimbursement claim databases covering the entire elderly population of Korea between January 2005 and June 2006. Given the nested structure of the data, a multivariate multilevel regression analysis was performed.


RESULTS
The average LOS was 128 days. Males, patients with schizophrenia, and those enrolled in a National Medical Care Aid program tended to have longer hospital stays. Patient age was negatively related to LOS. Institutional variables related to longer hospitalizations included a psychiatric hospital, a higher number of beds, fewer human resource employees, a higher proportion of male, oldest old, and patients with dementia.


CONCLUSIONS
Our results suggest that policies targeting geropsychiatric patients diagnosed with schizophrenia, enrolled in National Medical Care Aid programs, and admitted to psychiatric hospitals could reduce LOS. Additionally, the impact of the patient composition of a medical institution on LOS needs to be closely investigated.
Chung
Woojin
W
Department of Health Policy and Management, Graduate School of Public Health and Institute of Health Services Research, Yonsei University, Seoul 120-752, Republic of Korea.
Oh
Sun-Min
SM
Suh
Tongwoo
T
Lee
Young Moon
YM
Oh
Byoung Hoon
BH
Yoon
Chung-Won
CW
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005852:Geriatric Psychiatry / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007902:Length of Stay; D008297:Male; D008605:Mental Health Services; D056910:Republic of Korea; D012189:Retrospective Studies