title: The effects of state psychiatric hospital waitlist policies on length of stay and time to readmission.
abstract: This study examined the effects of a waitlist policy for state psychiatric hospitals on length of stay and time to readmission using data from North Carolina for 2004-2010. Cox proportional hazards models tested the hypothesis that patients were discharged "quicker-but-sicker" post-waitlist, as hospitals struggled to manage admission delays and quickly admit waitlisted patients. Results refute this hypothesis, indicating that waitlists were associated with increased length of stay and time to readmission. Further research is needed to evaluate patients' clinical outcomes directly and to examine the impact of state hospital waitlists in other areas, such as state hospital case mix, local emergency departments, and outpatient mental health agencies.
authors: Department of Health Policy and Management, University of North Carolina at Chapel Hill, Campus Box 7411, Chapel Hill, NC, 27599, USA, eholdsw@live.unc.edu.
authors: Elizabeth
authors: E
authors: Holdsworth La
authors: Ruoqing
authors: R
authors: Zhu
authors: Kristen
authors: K
authors: Hassmiller Lich
authors: Alan R
authors: AR
authors: Ellis
authors: Marvin S
authors: MS
authors: Swartz
authors: Michael R
authors: MR
authors: Kosorok
authors: Joseph P
authors: JP
authors: Morrissey
mesh_terms: D000293:Adolescent; D000328:Adult; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006783:Hospitals, State / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016134:Organizational Policy; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult