The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry.
International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients', psychiatric sectors' and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients' characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.
ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, 75010 Paris, France. coralie.gandre@urc-eco.fr.|AP-HP, URC Eco, DHU PePSY, 75004 Paris, France. coralie.gandre@urc-eco.fr.
Coralie
C
Gandré
ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, 75010 Paris, France. jeanne.gervaix@urc-eco.fr.|AP-HP, URC Eco, DHU PePSY, 75004 Paris, France. jeanne.gervaix@urc-eco.fr.
Jeanne
J
Gervaix
ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, 75010 Paris, France. julien.thillard@urc-eco.fr.|AP-HP, URC Eco, DHU PePSY, 75004 Paris, France. julien.thillard@urc-eco.fr.
Julien
J
Thillard
National Conservatory of Arts and Crafts, LIRSA, EA 4603, 75003 Paris, France. macejmarc@gmail.com.
Jean-Marc
JM
Macé
ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, 75010 Paris, France. jroelandt@epsm-lille-metropole.fr.|World Health Organization Collaborating Centre for Research and Training in Mental Health, 59000 Lille, France. jroelandt@epsm-lille-metropole.fr.
Jean-Luc
JL
Roelandt
ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, 75010 Paris, France. karine.chevreul@urc-eco.fr.|AP-HP, URC Eco, DHU PePSY, 75004 Paris, France. karine.chevreul@urc-eco.fr.
Karine
K
Chevreul
D000328:Adult; D004777:Environment; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D011570:Psychiatry / Q000458:organization & administration*
alternatives to full-time hospitalization; environmental characteristics; length of stay; mental health services; psychiatry