title: Determinants of psychogeriatric inpatient length of stay and direct medical costs: a 6-year longitudinal study using a national database in Taiwan.
abstract: OBJECTIVE
  This research examined factors related to the average length of hospital stay (LOS) and average direct medical costs (DMC) for 2291 psychogeriatric inpatients (aged 65 and over) admitted for the first time to a psychiatric ward in 2002.
  
  
  METHODS
  Hospitalization claim data of these inpatients were traced for the subsequent 6 years (2002-2007) from the dataset of Taiwan's National Health Insurance program. Analysis was carried out using the t-test, χ(2) -test and zero truncated Tobit regression.
  
  
  RESULTS
  Mean LOS and mean DMC were significantly different according to sex, psychiatric diagnosis, institution type, ownership type, and number of hospitalizations, but age was the exception. Both LOS and DMC exhibited downward U-shape for the number of hospitalizations. Factors significantly associated with longer LOS and higher DMC were: male sex; schizophrenic and delusional disorders (compared with dementia); and public institution (compared with private hospital). Compared with dementia, organic mental and anxiety disorders had significantly shorter LOS, and affective disorders had shorter LOS but higher DMC. Community and psychiatric hospitals (compared with general hospital) significantly influenced LOS but not DMC.
  
  
  CONCLUSIONS
  Our results can be used as a reference for providers and policymakers to improve psychiatric care efficiency and carry out National Health Insurance financial reform for psychogeriatric inpatients.
authors: PhD Program in Business             Department of Risk Management and Insurance, Feng Chia University             Department of Psychosomatics, Cheng Ching Hospital             Department of International Business, Asia University, Taichung, Taiwan.
authors: Chin-Ming
authors: CM
authors: Liu
authors: Chu-Shiu
authors: CS
authors: Li
authors: Chwen-Chi
authors: CC
authors: Liu
authors: Chu-Chin
authors: CC
authors: Tu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D016304:Hospitals, Private / Q000191:economics / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000191:economics / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000191:economics*; D019964:Mood Disorders / Q000191:economics; D009313:National Health Programs; D011567:Psychiatric Department, Hospital / Q000191:economics / Q000706:statistics & numerical data; D013624:Taiwan