Estimating Length of Stay and Duration of Illness for Psychiatric Inpatients using Multivariate Modelling (original) (raw)
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Predicting length of stay for patients with psychoses
Health Services Research
The Computerized Psychiatric Severity Index (CPSI) and 22 patient variables were used to predict length of hospitalization for 304 psychiatric patients in DRG 430 who were diagnosed with schizophrenia or affective disorder and had no secondary diagnoses. Length of stay, which correlated .96 with total charges, was used as the dependent variable (measure of resource use). The patient variables and CPSI score explained 32.5 percent of the variation in length of stay for all of DRG 430 (27.5 percent for affective disorder patients and 70.3 percent for schizophrenia patients). Addition of the treatment variable "receipt of ECT" (electroconvulsive therapy) permitted the regression models to explain 40.9 percent of the variation in length of stay (36.24 percent for affective disorder and 71.22 percent for schizophrenia). In each regression model, maximum CPSI score was significant, indicating that much heterogeneity in DRG 430 can be explained by CPSI. Using one payment for such...
Length of stay of acute psychiatric inpatients: an exponential model
Acta Psychiatrica Scandinavica, 1995
We examined the length of stay of inpatients admitted to a psychiatric unit in central London. The commonest length of stay (mode) was less than 1 week. In general, subsequent weeks showed successively fewer discharges, so that the distribution curve of the number of patients by length of stay showed a smooth decline. Analyzing the first 13 weeks of stay, the distribution curve corresponded very closely to a theoretical exponential decay curve. This has implications for recording the average length of stay and thus for comparing one hospital unit with another. It may also have implications for planning for acute psychiatric services. A plea is made for using the median rather than the mean for recording the average length of admission for some purposes.
2021
The global pandemic produced by COVID-19 has caused serious consequences for people's physical health. In addition, the governments of the most affected countries have carried out containment measures to prevent the spread of the virus. These quarantine measures have caused the growing of mental health problems. The present work aims to carry out a descriptive analysis of the main psychiatric pathologies that have been admitted to a hospitalization unit in 2019 and 2020. Besides, the differences between both years in duration of hospital stay, gender and age of the people admitted, or type of pathology will be tested. The results showed that in 2019 there were 251 admissions with an average duration of 19.29 days (SD = 33.95). In 2020, 230 admissions with a duration of 12.07 (SD = 16.49). The test t for independent samples was significant (t = 2.92; p < .000). On the other hand, there were no differences in the number of women or men admitted. Regarding the type of pathology,...
علوم بهداشتی ایران, 2020
Background and Purpose: Length of stay is one of the most useful indicators, which can be used for aims, such as managing hospital, determining quality of control and available resources of the hospital. Concerning the high prevalence of psychiatric disorders in the community, studying the factors affecting the length of stay of these patients in psychiatric hospitals seemed to be useful and significant. Materials and methods: The present research was a cross-sectional study. The sample consisted of 152 patients with psychiatric disorders hospitalized in the Psychiatry Hospital of Mazandaran University of Medical Sciences. The final diagnosis of psychiatric disorder based on the DSM-V criteria and the length of stay at the end was recorded. The collected data were then analyzed by SPSS Software ver. 16 Results: Length of stay was significantly higher in men than women (p <0.001). In terms of diagnosis, the maximum duration of hospitalization was related to psychotic disorders (p = 0.001), and the length of stay increased significantly 0.21 day for each time of hospitalization. (p=0.008) Conclusion: The length of stay in men with psychotic disorders and more frequent hospitalization was found to be higher than others. Hence, it seemed necessary to consider plans about these patients.
Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 2017
There have been significant reductions in numbers of psychiatric beds and length of stay (LOS) worldwide, making LOS in psychiatric beds an interesting outcome. The objective of this study was to find factors measurable on admission that would predict LOS in the acute psychiatric setting. This was a prospective, observational study. Overall, 385 subjects were included. The median LOS was 25 days. In the final model, six variables explained 14.6% of the variation in LOS: not having own income, psychiatric admissions in the preceding 2 years, high Clinical Global Impression and Brief Psychiatric Rating Scale scores, diagnosis of schizophrenia, and history of attempted suicide. All variables were associated with longer LOS, apart from history of attempted suicide. Identifying patients who will need to stay longer in psychiatric beds remains a challenge. Improving knowledge about determinants of LOS could lead to improvements in the quality of care in hospital psychiatry.
BMC health services research, 2004
Length of stay (LOS) is an important indicator of efficiency for inpatient care but it does not achieve an adequate performance if it is not adjusted for the case mix of the patients hospitalized during the period considered. After two similar studies for Internal Medicine and Surgery respectively, the aims of the present study were to search for Length of Stay (LOS) predictors in an acute psychiatric department and to assess the performance of the difference: observed-predicted length of stay, as an indicator of inpatient care inefficiencies. Retrospective case-series of patients discharged during 1999 from the Psychiatric Department from General Hospital "Hermanos Ameijeiras" in Havana, Cuba. The 374 eligible medical records were randomly split into two groups of 187 each. We derived the function for estimating the predicted LOS within the first group. Possible predictors were: age; sex; place of residence; diagnosis, use of electroconvulsive therapy; co morbidities; sym...
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Three approaches to the study of mental illness are examined: the medical,the behavioral, and the societal reaction models. Operational measures of each model are presented and used to determine the relationship between the measures and duration of institutionalization and the relative importance of the three models in predicting duration of institutionalization.
BMC health services research, 2018
With the increasing burden of mental illness globally, it is becoming common for hospitalised patients with chronic medical conditions to have a comorbidity of mental illness. This combination could prolong length of stay (LOS) of this patient cohort. We conducted an investigation in Tasmania, Australian hospitals to characterise this cohort and assess if co-morbidity of mental illness is a distinguishing factor that generates LOS variation across different chronic medical conditions. The retrospective study analysed 16,898 admissions of patients with a primary diagnosis of one of five chronic medical conditions: lung or colorectal cancer, chronic obstructive pulmonary disease (COPD), type II diabetes, ischaemic heart disease (IHD) and stroke. Data were from July 2010 to June 2015, across four hospitals that collectively cover 95% of public hospital admissions in Tasmania, Australia. Descriptive statistics were used to compare characteristics of patients between the scenarios of wit...
Statistical analysis on length of stay in hospital
Science & Technology Development Journal - Engineering and Technology, 2021
The rising financial problems of healthcare institutions make studies of resource distribution more and more important and valuable. Among these studies, identification of length of stay of hospital patients (LOS) has attracted many scientists recently since it contributes to better knowledge of hospital costs and helps these institutions control the costs. This paper is devoted to study the length of stay of inpatients in hospital. Although predicting the length of stay is difficul, it is actually useful and benificial if some key factors that have influence on patient length of stay could be determined. This paper will be the basis for a running example that illustrates alternative models of the length of stay of hospital pentients. A total of 1189 episodes, which contains patient records, were analyzed by using some parametric and nonparametric statistical methods. In this study, several factors are first considered and investigated, including date of admission, medical admission...