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Administration and Policy in Mental Health and Mental Health Services Research

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01.05.2011 | Original Paper

Length of Stay of General Psychiatric Inpatients in the United States: Systematic Review

verfasst von: Alex D. Tulloch, Paul Fearon, Anthony S. David

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 3/2011

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Abstract

Psychiatric length of stay (LOS) has reduced but is still longer than for physical disorders. Inpatient costs are 16% of total mental health spending. Regression analyses of the determinants of LOS for US adult psychiatric inpatients were systematically reviewed. Most studies predated recent LOS reductions. Psychosis, female gender and larger hospital size were associated with longer LOS, while discharge against medical advice, prospective payment, being married, being detained and either younger or middle age were associated with shorter LOS. Associations appeared consistent, especially where sample size was above 3,000. Updated studies should be adequately powered and include the variables above.

Eleven variables were measured in three analyses: doctors per capita, ECT and major procedures including ECT, employed, comorbid personality disorder, prior authorization/pre-admission screening, public ownership, region, seclusion and restraint, urban location, utilization review (excluding the effect of Medicaid utilization review on non-Medicaid patients in Frank and Lave 1986), and violence. 18 variables were measured in 2 analyses: active military duty, area wage index, death at discharge, divorced, expected gain for hospital from prospective payment, hospital with disproportionate low income patients, number of acute beds, partial hospitalisation program, proprietary ownership, psychiatric beds per capita, psychiatric emergency room, psychiatric longstay beds, psychiatric OPD, rural referral center, short-term beds per capita, sole community hospital, treating psychiatrist, years of education. 37 variables were measured in 1 analysis: admission via ER, attending is a psychiatrist, bed occupancy, change of diagnosis, dependents, disability benefits, discharge to daycare, discharge to private psychiatrist, discharged home, disease stage, doctors per bed, duration of symptoms, early readmission, family meeting held, family history of psychiatric illness, general hospital with alcohol unit, general hospital with psychiatric unit, homelessness, hospital, level of function scale, MMSE score, nurses per bed, paranoia, physical abuse, past psychiatric history, private attending psychiatrist, private ownership, separated, sexual abuse, specific drug treatment, suicidality, Trails A score, unit, violence with schizophrenia, voluntary ownership, VR score, widowed.

Agency for Healthcare Research and Quality. (2009). NIS description of data elements. 4 11/4 11. Retrieved from http://www.hcup-us.ahrq.gov/db/nation/nis/nisdde.jsp.

Allen, J. G., Beale, D. A., Newsom, G. E., Coyne, L., Spohn, H. E., Beasley, C., et al. (1984). A research design to predict required length of psychiatric hospital stay. Psychiatric Hospital, 15(4), 185–191.PubMed

Allen, J. G., Coyne, L., Lyle, J., & Spohn, H. E. (1992). Assessing need for extended psychiatric hospitalization. Comprehensive Psychiatry, 33(5), 346–352.PubMedCrossRef

Allen, J. G., Tarnoff, G., & Coyne, L. (1985a). Therapeutic alliance and long-term hospital treatment outcome. Comprehensive Psychiatry, 26(2), 187–194.PubMedCrossRef

Allen, J. G., Tarnoff, G., Coyne, L., & Spohn, H. E. (1985b). Actual versus optimal length of psychiatric hospital stay. An important distinction for prediction. Bulletin of the Menninger Clinic, 49(5), 500–506.PubMed

Anderson, S. W., Crist, A. J., & Payne, N. (2004). Predicting inpatient length of stay with the expanded version of the brief psychiatric rating scale (version 4.0). Psychiatric Services, 55(1), 77–79. doi:10.1176/appi.ps.55.1.77.PubMedCrossRef

Ashcraft, M. L., Fries, B. E., Nerenz, D. R., Falcon, S. P., Srivastava, S. V., Lee, C. Z., et al. (1989). A psychiatric patient classification system. An alternative to diagnosis-related groups. Medical Care, 27(5), 543–557.PubMedCrossRef

*Bezold, H. S., MacDowell, M., & Kunkel, R. (1996). Predicting psychiatric length of stay. Administration and Policy in Mental Health, 23(5), 407–423.

*Blais, M. A., & Baity, M. R. (2005). A comparison of two mental status examinations in an inpatient psychiatric sample. Assessment, 12(4), 455–461.

Blais, M. A., Matthews, J., Lipkis-Orlando, R., Lechner, E., Jacobo, M., Lincoln, R., et al. (2003). Predicting length of stay on an acute care medical psychiatric inpatient service. Administration and Policy in Mental Health, 31(1), 15–29.PubMedCrossRef

*Boelhouwer, C., & Rosenberg, M. (1983). Length of stay: A retrospective computer analysis. Psychiatric Annals, 13(8), 605–611.

Bolden, L., & Wicks, M. N. (2005). Length of stay, admission types, psychiatric diagnoses, and the implications of stigma in African Americans in the nationwide inpatient sample. Issues in Mental Health Nursing, 26(10), 1043–1059.PubMedCrossRef

Boot, B., Hall, W., & Andrews, G. (1997). Disability, outcome and case-mix in acute psychiatric in-patient units. The British Journal of Psychiatry, 171(3), 242–246. doi:10.1192/bjp.171.3.242.PubMedCrossRef

Bradley, C. J., & Zarkin, G. A. (1996). Inpatient stays for patients diagnosed with severe psychiatric disorders and substance abuse. Health Services Research, 31(4), 387–408.PubMed

*Brock, I. P., & Brown, G. R. (1993). Psychiatric length of stay determinants in a military medical center. General Hospital Psychiatry, 15(6), 392–398.

Bromet, E. J., Schwartz, J. E., Fennig, S., Geller, L., Jandorf, L., Kovasznay, B., et al. (1992). The epidemiology of psychosis: The Suffolk County Mental Health Project. Schizophrenia Bulletin, 18(2), 243–255.PubMed

Brown, S. L. (2001). Variations in utilization and cost of inpatient psychiatric services among adults in Maryland. Psychiatric Services, 52(6), 841–843.PubMedCrossRef

Brown, T. M., Miller, H. L., Ekstrom, D., Evans, D. L., & Golden, R. N. (1991). Characteristics of long-stay patients on the psychiatric service of a university hospital. Hospital & Community Psychiatry, 42(7), 743–745.

Browning, D. L. (1986). Psychiatric ward behavior and length of stay in adolescent and young adult inpatients: A developmental approach to prediction. Journal of Consulting and Clinical Psychology, 54(2), 227–230.PubMedCrossRef

Bruml, H., & King, C. (1978). Emergency service admissions to a state mental hospital. Virginia Medical, 105(9), 630–632.PubMed

Caton, C. L., & Gralnick, A. (1987). A review of issues surrounding length of psychiatric hospitalization. Hospital & Community Psychiatry, 38(8), 858–863.

Chang, G., Brenner, L., & Bryant, K. (1991). Factors predicting inpatient length of stay in a CMHC. Hospital & Community Psychiatry, 42(8), 853–855.

Cho, D. W., Hsu, Y., & Monroe, S. (1981). A computerized mental patient classification system. Computer Programs in Biomedicine, 13(1–2), 139–147.PubMedCrossRef

Choca, J. P., Peterson, C. A., Shanley, L. A., Richards, H., & Mangoubi, E. (1988). Problems in using statistical models to predict psychiatric length of stay: An illustration. Hospital & Community Psychiatry, 39(2), 195–197.

Citrome, L., Green, L., & Fost, R. (1994). Length of stay and recidivism on a psychiatric intensive care unit. Hospital & Community Psychiatry, 45(1), 74–76.

Clarkin, J. F., & Glick, I. D. (1982). Duration of hospitalization as a variable in outcome. Psychiatric Hospital, 13(2), 50–54.PubMed

Coffey, R. M., Buck, J. A., Kassed, C. A., Dilonardo, J., Forhan, C., Marder, W. D., et al. (2008). Transforming mental health and substance abuse data systems in the United States. Psychiatric Services, 59(11), 1257–1263. doi:10.1176/appi.ps.59.11.1257.PubMedCrossRef

*Compton, M. T., Craw, J., & Rudisch, B. E. (2006). Determinants of inpatient psychiatric length of stay in an urban county hospital. Psychiatric Quarterly, 77(2), 173–188.

Cotterill, P. G., & Thomas, F. G. (2004). Prospective payment for Medicare inpatient psychiatric care: Assessing the alternatives. Health Care Financing Review, 26(1), 85–101.PubMed

*Crowe, D. B., Rosse, R. B., Sheridan, M. J., & Deutsch, S. I. (1991). Substance use diagnoses and discharge patterns among psychiatric inpatients. Hospital & Community Psychiatry, 42(4), 403–405.

Davis, G. C., & Breslau, N. (1984). DRGs and the practice of psychiatry. Medical Care, 22(7), 595–596.PubMedCrossRef

Department of Veterans Affairs. (2008). Patient treatment file (PTF) coding instructions. Retrieved January 14, 2008, from http://www1.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=1650.

Durbin, J., Goering, P., Pink, G., & Murray, M. (1999). Classifying psychiatric inpatients: Seeking better measures. Medical Care, 37(4), 415–423.PubMedCrossRef

Elixhauser, A., Steiner, C., Harris, D. R., & Coffey, R. M. (1998). Comorbidity measures for use with administrative data. Medical Care, 36(1), 8–27.PubMedCrossRef

Ellis, R. P., & McGuire, T. G. (1986). Provider behavior under prospective reimbursement: Cost sharing and supply. Journal of Health Economics, 5(2), 129–151.PubMedCrossRef

Ellis, R. H., Wackwitz, J. H., & Foster, M. (1991). Uses of an empirically derived client typology based on level of functioning: Twelve years of the CCAR. Journal of Mental Health Administration, 18(2), 88–100.PubMedCrossRef

English, J. T., & McCarrick, R. G. (1986). DRGs: An overview of the issues. General Hospital Psychiatry, 8(5), 359–364.PubMedCrossRef

English, J. T., Sharfstein, S. S., Scherl, D. J., Astrachan, B., & Muszynski, I. L. (1986). Diagnosis-related groups and general hospital psychiatry: The APA study. American Journal of Psychiatry, 143(2), 131–139.PubMed

Essock, S. M. (1987). The influence of medical comorbidities and other patient characteristics on resource consumption on psychiatric wards. Advances in Health Economics and Health Services Research, 8, 133–142.PubMed

Essock-Vitale, S. (1987). Patient characteristics predictive of treatment costs on inpatient psychiatric wards. Hospital & Community Psychiatry, 38(3), 263–269.

Evans-Lacko, S. E., Jarrett, M., McCrone, P., & Thornicroft, G. (2008). Clinical pathways in psychiatry. British Journal of Psychiatry, 193(1), 4–5. doi:10.1192/bjp.bp.107.048926.PubMedCrossRef

Fetter, R. B., Shin, Y., Freeman, J. L., Averill, R. F., & Thompson, J. D. (1980). Case mix definition by diagnosis-related groups. Medical Care, 18(2 Suppl), 1–53. iii.

Fisher, W. H., Barreira, P. J., Lincoln, A. K., Simon, L. J., White, A. W., Roy-Bujnowski, K., et al. (2001). Insurance status and length of stay for involuntarily hospitalized patients. Journal of Behavioral Health Services & Research, 28(3), 334–346.CrossRef

Frank, R. G., Goldman, H. H., & McGuire, T. G. (2009). Trends in mental health cost growth: An expanded role for management? Health Affairs, 28(3), 649–659. doi:10.1377/hlthaff.28.3.649.PubMedCrossRef

Frank, R. G., & Lave, J. R. (1985a). The impact of Medicaid benefit design on length of hospital stay and patient transfers. Hospital & Community Psychiatry, 36(7), 749–753.

Frank, R. G., & Lave, J. R. (1985b). The psychiatric DRGs. Are they different? Medical Care, 23(10), 1148–1155.PubMedCrossRef

Frank, R. G., & Lave, J. R. (1985c). A plan for prospective payment for inpatient psychiatric care. Hospital & Community Psychiatry, 36(7), 775–776.

*Frank, R. G., & Lave, J. R. (1986). The effect of benefit design on the length of stay of Medicaid psychiatric patients. Journal of Human Resources, 21(3), 321–337.

Frank, R. G., & Lave, J. R. (1989). A comparison of hospital responses to reimbursement policies for Medicaid psychiatric patients. RAND Journal of Economics, 20(4), 588–600.PubMedCrossRef

Frank, R. G., Lave, J. R., Taube, C. A., Rupp, A., & Goldman, H. H. (1987). The impact of Medicare’s prospective payment system on psychiatric patients treated in scatterbeds. Advances in Health Economics and Health Services Research, 8, 1–21.PubMed

*Freiman, M. P., Ellis, R. P., & McGuire, T. G. (1989). Provider response to Medicare’s PPS: Reductions in length of stay for psychiatric patients treated in scatter beds. Inquiry, 26(2), 192–201.

Glick, M., Marsh, A., & Zigler, E. (1980). Inter-relationships among hospitalization measures of psychiatric outcome. Journal of Nervous and Mental Disease, 168(12), 741–744.PubMedCrossRef

Goffman, E. (1968). Asylums. London: Penguin Books.

Goldman, H. H., Pincus, H. A., Taube, C. A., & Regier, D. A. (1984). Prospective payment for psychiatric hospitalization: Questions and issues. Hospital & Community Psychiatry, 35(5), 460–464.

Goldstein, J. M., Bassuk, E. L., Holland, S. K., & Zimmer, D. (1988). Identifying catastrophic psychiatric cases. Targeting managed-care strategies. Medical Care, 26(8), 790–799.PubMedCrossRef

Gordon, R. E., Jardiolin, P., & Gordon, K. K. (1985a). Predicting length of hospital stay of psychiatric patients. American Journal of Psychiatry, 142(2), 235–237.PubMed

Gordon, R. E., Vijay, J., Sloate, S. G., Burket, R., & Gordon, K. K. (1985b). Aggravating stress and functional level as predictors of length of psychiatric hospitalization. Psychiatric Services, 36(7), 773–774.

Greenberg, R. P., & Bornstein, R. F. (1989). Length of psychiatric hospitalization and oral dependency. Journal of Personality Disorders, 3(3), 199–204.CrossRef

*Greenfield, T. K., McNiel, D. E., & Binder, R. L. (1989). Violent behavior and length of psychiatric hospitalization. Hospital & Community Psychiatry, 40(8), 809–814.

Gruber, J. E. (1982). Paths and gates: The sources of recidivism and length of stay on a psychiatric ward. Medical Care, 20(12), 1197–1208.PubMedCrossRef

Gurel, L. (1966). Release and community stay criteria in evaluating psychiatric treatment. In P. H. Hoch & J. Zubin (Eds.), Psychopathology of Schizophrenia (pp. 527–561). New York: Grune and Stratton, Inc.

Hayden, J. A., Cote, P., & Bombardier, C. (2006). Evaluation of the quality of prognosis studies in systematic reviews. Annals of Internal Medicine, 144(6), 427–437.PubMed

Heiman, E. M., & Shanfield, S. B. (1980). Length of stay for patients in one city’s hospitals with psychiatric units. Hospital & Community Psychiatry, 31(9), 632–634.

Hendryx, M. S., & DeRyan, J. (1998). Psychiatric hospitalization characteristics associated with insurance type. Administration and Policy in Mental Health, 25(4), 437–448.PubMedCrossRef

Hermann, R. C., Rollins, C. K., & Chan, J. A. (2007). Risk-adjusting outcomes of mental health and substance-related care: A review of the literature. Harvard Review of Psychiatry, 15(2), 52–69. doi:10.1080/10673220701307596.PubMedCrossRef

Hirdes, J., Fries, B., Botz, C., Ensley, C., Marhaba, M., & Perez, E. (2003). The system for classification of in-patient psychiatry (SCIPP): A new case-mix methodology based on the RAI-Mental Health (RAI-MH). Waterloo: Department of Health Studies and Gerontology. Retrieved from http://www.jppc.org/new/files/acrobat/ScippCaseMixMH2003.pdf.

Hodgson, R., Lewis, M., & Boardman, J. (2000). The prediction of in-patient length of stay for acute psychiatric admissions. Journal of Mental Health, 9(2), 145–153. doi:10.1080/09638230050009140.CrossRef

Horn, S. D., Chambers, A. F., Sharkey, P. D., & Horn, R. A. (1989). Psychiatric severity of illness: A case mix study. Medical Care, 27(1), 69–84.PubMedCrossRef

*Huntley, D. A., Cho, D. W., Christman, J., & Csernansky, J. G. (1998). Predicting length of stay in an acute psychiatric hospital. Psychiatric Services, 49(8), 1049–1053.

Jencks, S. F., Goldman, H. H., & McGuire, T. G. (1985). Challenges in bringing exempt psychiatric services under a prospective payment system. Hospital & Community Psychiatry, 36(7), 764–769.

Jencks, S. F., Horgan, C., Goldman, H. H., & Taube, C. A. (1987). Bringing excluded psychiatric facilities under the Medicare prospective payment system—a review of research evidence and policy options. Medical Care, 25(9), S1–S50.PubMed

Johnstone, P., & Zolese, G. (1999). Systematic review of the effectiveness of planned short hospital stays for mental health care. BMJ, 318(7195), 1387–1390.PubMed

*Kato, K., Galynker, I. I., Miner, C. R., & Rosenblum, J. L. (1995). Cognitive impairment in psychiatric patients and length of hospital stay. Comprehensive Psychiatry, 36(3), 213–217.

Katz, P. S. (1984). Prospective payment and mental health. QRB Quality Review Bulletin, 10(11), 355–358.PubMed

Kiesler, C. A., Simpkins, C., & Morton, T. (1990). Predicting length of hospital stay for psychiatric inpatients. Hospital & Community Psychiatry, 41(2), 149–154.

Kiesler, C. A., Sibulkin, A. E., Morton, T. L., & Simpkins, C. G. (1991). Characteristics of psychiatric discharges from nonfederal, short-term specialty hospitals and general hospitals with and without psychiatric and chemical dependency units: the Hospital Discharge Survey data. Health Services Research, 25(6), 881–906.PubMed

Kirshner, L. A. (1982). Length of stay of psychiatric patients. A critical review and discussion. Journal of Nervous and Mental Disease, 170(1), 27–33.PubMedCrossRef

Kirshner, L. A., & Johnston, L. (1983). Effects of gender on inpatient psychiatric hospitalization. Journal of Nervous and Mental Disease, 171(11), 651–657.PubMedCrossRef

*Kirshner, L. A., & Johnston, L. (1985). Length of stay on a short-term unit. General Hospital Psychiatry, 7(2), 149–155.

Kirstein, L. (1978). Sociodemographic factors and military psychiatric hospitalization. Journal of Nervous and Mental Disease, 166(4), 299–303.PubMedCrossRef

Kleespies, P. M. (1986). Hospital milieu treatment and optimal length of stay. Hospital & Community Psychiatry, 37(5), 509–510.

Lave, J. R. (2003). Developing a Medicare prospective payment system for inpatient psychiatric care. Health Affairs, 22(5), 97–109. doi:10.1377/hlthaff.22.5.97.PubMedCrossRef

Lave, J. R., & Frank, R. G. (1988). Factors affecting Medicaid patients’ length of stay in psychiatric units. Health Care Financing Review, 10(2), 57–66.PubMed

*Lave, J. R., & Frank, R. G. (1990a). Effect of the structure of hospital payment on length of stay. Health Services Research, 25(2), 327–347.

*Lave, J. R., & Frank, R. G. (1990b). Hospital supply response to prospective payment as measured by length of stay. Advances in Health Economics and Health Services Research, 11, 1–25.

Lee, H. S. (1979). Patients’ comments on psychiatric inpatient treatment experiences: Patient–therapist relationships and their implications for treatment outcome. Psychiatric Quarterly, 51(1), 39–54.PubMedCrossRef

Lee, E. S., Forthofer, R. N., & Taube, C. A. (1985). Does DRG mean disastrous reimbursement groupings for psychiatric hospitals? Journal of Health & Human Resources Administration, 8(1), 53–78.

Lehman, A. F., Strauss, J. S., Ritzler, B. A., Kokes, R. F., Harder, D. W., & Gift, T. E. (1982). First-admission psychiatric ward milieu: Treatment process and outcome. Archives of General Psychiatry, 39(11), 1293–1298.PubMed

Levine, M. S., Weiner, O. D., & Carone, P. F. (1978). Monitoring inpatient length of stay in a community mental health center. Journal of Nervous and Mental Disease, 166(9), 655–660.PubMedCrossRef

Light, D. W., Phipps, E. J., Piper, G. E., Rissmiller, D. J., Mobilio, J. N., & Ranieri, W. F. (1986). Finding psychiatric diagnosis-related groups that work: A call for research. American Journal of Psychiatry, 143(5), 622–624.PubMed

Lyketsos, C. G., Dunn, G., Kaminsky, M. J., & Breakey, W. R. (2002). Medical comorbidity in psychiatric inpatients: Relation to clinical outcomes and hospital length of stay. Psychosomatics, 43(1), 24–30.CrossRef

Lyons, J. S., & McGovern, M. P. (1989). Use of mental health services by dually diagnosed patients. Hospital & Community Psychiatry, 40(10), 1067–1069.

*Lyons, J. S., O’Mahoney, M. T., & Larson, D. B. (1991). The attending psychiatrist as a predictor of length of stay. Hospital & Community Psychiatry, 42(10), 1064–1066.

Marsh, A., Glick, M., & Zigler, E. (1981). Premorbid social competence and the revolving door phenomenon in psychiatric hospitalization. Journal of Nervous and Mental Disease, 169(5), 315–319.PubMedCrossRef

Mason, J. C., Louks, J., & Backus, F. (1985). Patient-predicted length of stay and diagnosis-related-group reimbursement. American Journal of Psychiatry, 142(3), 369–371.PubMed

McCrone, P. (1995). Predicting mental health service use: Diagnosis based systems and alternatives. Journal of Mental Health, 4(1), 31–40.CrossRef

McCrone, P., & Phelan, M. (1994). Diagnosis and length of psychiatric in-patient stay. Psychological Medicine, 24(04), 1025–1030. doi:10.1017/S003329170002910X.PubMedCrossRef

McGuire, T. G., Dickey, B., Shively, G. E., & Strumwasser, I. (1987). Differences in resource use and cost among facilities treating alcohol, drug abuse, and mental disorders: Implications for design of a prospective payment system. American Journal of Psychiatry, 144(5), 616–620.PubMed

McGuire, J., & Mares, A. (2000). Hoptel equalizes length of stay for homeless and domiciled inpatients. Medical Care, 38(10), 1003–1010.PubMedCrossRef

*McLay, R. N., Daylo, A., & Hammer, P. S. (2005). Predictors of length of stay in a psychiatric ward serving active duty military and civilian patients. Military Medicine, 170(3), 219–222.

McMahon, L. F., & Newbold, R. M. M. (1986). Variation in resource use within diagnosis-related groups: The effect of severity of illness and physician practice. Medical Care, 24(5), 388–397.PubMedCrossRef

Mechanic, D., McAlpine, D. D., & Olfson, M. (1998). Changing patterns of psychiatric inpatient care in the United States, 1988–1994. Archives of General Psychiatry, 55(9), 785–791. doi:10.1001/archpsyc.55.9.785.PubMedCrossRef

Mezzich, J. E., & Sharfstein, S. S. (1985). Severity of illness and diagnostic formulation: Classifying patients for prospective payment systems. Hospital & Community Psychiatry, 36(7), 770–772.

Mitchell, J. B., Dickey, B., Liptzin, B., & Sederer, L. I. (1987). Bringing psychiatric patients into the Medicare prospective payment system: Alternatives to DRGs. American Journal of Psychiatry, 144(5), 610–615.PubMed

National Center for Health Statistics. (2010). Health United States, 2009: With special feature on medical technology. Hyattsville, MD: National Center for Health Statistics.

Okin, R. L. (1986). The relationship between legal status and patient characteristics in state hospitals. American Journal of Psychiatry, 143(10), 1233–1237.PubMed

Ortega, S. T., & Rushing, W. A. (1984). The interaction of structural variables and discretion in individual outcomes: The case of the length of stay for mental patients. Sociological Quarterly, 25(4), 496–510.CrossRef

Patrick, J. (1984). Predicting outcome of psychiatric hospitalization: A comparison of attitudinal and psychopathological measures. Journal of Clinical Psychology, 40(2), 546–549.PubMedCrossRef

Patrick, J. (1985). The relationship between the Wiggins’ PSY scale and length of hospitalization: A re-examination. Journal of Clinical Psychology, 41(3), 386–388.PubMedCrossRef

Peteroy, E. T., Pirrello, P. E., & Adams, N. (1982). The relationship between two Wiggins Content Scales and length of hospitalization. Journal of Clinical Psychology, 38(2), 344–346.PubMedCrossRef

Pierce, G. L., Fisher, W. H., & Durham, M. L. (1985). The impact of broadened civil commitment laws on length of stay in a state mental hospital. Law, Medicine & Health Care, 13(6), 290–296.

Prentky, R. A., Lewine, R. R., Watt, N. F., & Fryer, J. H. (1980). A longitudinal study of psychiatric outcome: Developmental variables vs. psychiatric symptoms. Schizophrenia Bulletin, 6(1), 139–148.PubMed

Priest, R. G., Raptopoulos, P., & Chan, M. L. (1979). Psychiatric patients: How long do they stay? Lancet, 2(8132), 40–41.PubMedCrossRef

Quinn, K. (2008). New directions in Medicaid payment for hospital care. Health Affairs, 27(1), 269–280. doi:10.1377/hlthaff.27.1.269.PubMedCrossRef

*Rupp, A., Steinwachs, D. M., & Salkever, D. S. (1985). Hospital payment effects on acute inpatient care for mental disorders. Archives of General Psychiatry, 42(6), 552–555.

Salit, S. A., Kuhn, E. M., Hartz, A. J., Vu, J. M., & Mosso, A. L. (1998). Hospitalization costs associated with homelessness in New York City. New England Journal of Medicine, 338(24), 1734–1740 [see comment].PubMedCrossRef

Schubert, D. S. P. (1995). Impact of the interaction of depression and physical illness on a psychiatric unit’s length of stay. General Hospital Psychiatry, 17(5), 326–334. doi:10.1016/0163-8343%2895%2900065-Y.PubMedCrossRef

Schumacher, D. N., Namerow, M. J., Parker, B., Fox, P., & Kofie, V. (1986). Prospective payment for psychiatry—feasibility and impact. New England Journal of Medicine, 315(21), 1331–1336.PubMedCrossRef

Schwarz, C., & Valiance, M. (1987). Length of stay. Hospital & Community Psychiatry, 38(2), 201.

Seidman, R. L., & Frank, R. G. (1985). Hospital responses to incentives in alternative reimbursement systems. Journal of Behavioral Economics, 14(1), 155–180. doi:10.1016/0090-5720(85)90011-7.CrossRef

Shwartz, M., Merrill, J. C., & Blake, L. K. (1984). DRG-based case mix and public hospitals. Medical Care, 22(4), 283–299.PubMedCrossRef

Siegel, C., Alexander, M. J., Lin, S., & Laska, E. (1986). An alternative to DRGs. A clinically meaningful and cost-reducing approach. Medical Care, 24(5), 407–417.PubMedCrossRef

Sloan, D. M., Yokley, J., Gottesman, H., & Schubert, D. S. (1999). A five-year study on the interactive effects of depression and physical illness on psychiatric unit length of stay. Psychosomatic Medicine, 61(1), 21–25.PubMed

Stanton, A. H., & Schwartz, M. S. (1954). The mental hospital: A study of institutional participation in psychiatric illness and treatment. New York: Basic Books.CrossRef

*Stern, S., Merwin, E., & Holt, F. (2001). Survival models of community tenure and length of hospital stay for the seriously mentally ill: A 10-year perspective. Health Services and Outcomes Research Methodology, 2(2), 117–135. doi:10.1023/A:1020154012982.

Stevens, A., Hammer, K., & Buchkremer, G. (2001). A statistical model for length of psychiatric in-patient treatment and an analysis of contributing factors. Acta Psychiatrica Scandinavica, 103(3), 203–211. doi:10.1034/j.1600-0447.2001.00043.x.PubMedCrossRef

Stewart, R., Soremekun, M., Perera, G., Broadbent, M., Callard, F., Denis, M., et al. (2009). The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: Development and descriptive data. BMC Psychiatry, 9(1), 51. doi:10.1186/1471-244X-9-51.PubMedCrossRef

Tardiff, K. (1989). Violent behavior and length of hospitalization. Hospital & Community Psychiatry, 40(8), 781.

Taube, C. A., Goldman, H. H., & Lee, E. S. (1988). Use of specialty psychiatric settings in constructing DRGs. Archives of General Psychiatry, 45(11), 1037.PubMed

Taube, C., Lee, E. S., & Forthofer, R. N. (1984a). Diagnosis-related groups for mental disorders, alcoholism, and drug abuse: Evaluation and alternatives. Hospital & Community Psychiatry, 35(5), 452–455.

Taube, C., Lee, E. S., & Forthofer, R. N. (1984b). DRGs in psychiatry. An empirical evaluation. Medical Care, 22(7), 597–610.PubMedCrossRef

Taube, C. A., Thompson, J. W., Burns, B. J., Widem, P., & Prevost, C. (1985). Prospective payment and psychiatric discharges from general hospitals with and without psychiatric units. Hospital & Community Psychiatry, 36(7), 754–760.

Tucker, P., & Brems, C. (1993). Variables affecting length of psychiatric inpatient treatment. Journal of Mental Health Administration, 20(1), 58–65.PubMedCrossRef

Tulloch, A. D., Fearon, P., & David, A. S. (2008). The determinants and outcomes of long-stay psychiatric admissions—a case–control study. Social Psychiatry and Psychiatric Epidemiology, 43(7), 569–574. doi:10.1007/s00127-008-0332-2.PubMedCrossRef

von Korff, M. (1979). A statistical model of the duration of mental hospitalization: The mixed exponential distribution. Journal of Mathematical Sociology, 6(2), 169–175.CrossRef

*Wallen, J. (1987). Resource use by psychiatric patients in community hospitals: The influence of illness severity, physician specialty, and presence of a psychiatric unit. Advances in Health Economics and Health Services Research, 8, 103–126.

Widem, P., Pincus, H. A., Goldman, H. H., & Jencks, S. (1984). Prospective payment for psychiatric hospitalization: Context and background. Hospital & Community Psychiatry, 35(5), 447–451.

Zanni, G. R., & Peele, R. (1986). The “strain ratio” in predicting length of stay. American Journal of Psychiatry, 143(3), 393–394.PubMed

Zigler, E., Glick, M., & Marsh, A. (1979). Premorbid social competence and outcome among schizophrenic and nonschizophrenic patients. Journal of Nervous and Mental Disease, 167(8), 478–483.PubMedCrossRef

Titel: Length of Stay of General Psychiatric Inpatients in the United States: Systematic Review
verfasst von: Alex D. Tulloch
Paul Fearon
Anthony S. David
Publikationsdatum: 01.05.2011
Verlag: Springer US
Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 3/2011
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-010-0310-3

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