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Predictors of length of stay in psychiatric inpatient units : does their effect vary across countries?
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Dimitri, Giorgia, Giacco, Domenico, Bauer, Michael, Bird, Victoria Jane, Greenberg, Lauren, Lasalvia, Antonio, Lorant, Vincent, Moskalewicz, Jacek, Nicaise, Pablo, Pfennig, Andrea, Ruggeri, Mirella, Welbel, Marta and Priebe, Stefan (2018) Predictors of length of stay in psychiatric inpatient units : does their effect vary across countries? European Psychiatry, 48 (1). pp. 6-12. doi:10.1016/j.eurpsy.2017.11.001 ISSN 0924-9338.
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Official URL: http://dx.doi.org/10.1016/j.eurpsy.2017.11.001
Abstract
Background
Previous studies in individual countries have identified inconsistent predictors of length of stay (LoS) in psychiatric inpatient units. This may reflect methodological inconsistencies across studies or true differences of predictors. In this study we assessed predictors of LoS in five European countries and explored whether their effect varies across countries.
Methods
Prospective cohort study. All patients admitted over 14 months to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and United Kingdom were screened. Putative predictors were collected from medical records and in face-to-face interviews and tested for their association with LoS.
Results
Average LoS varied from 17.9 days in Italy to 55.1 days in Belgium. In the overall sample being homeless, receiving benefits, social isolation, diagnosis of psychosis, greater symptom severity, substance use, history of previous admission and being involuntarily admitted predicted longer LoS. Several predictors showed significant interaction effects with countries in predicting LoS. One variable, homelessness, predicted a different LoS even in opposite directions, whilst for other predictors the direction of the association was the same, but the strength of the association with LoS varied across countries.
Conclusions
The same patient characteristics have a different impact on LoS in different contexts. Thus, although some predictor variables related to clinical severity and social dysfunction appear of generalisable relevance, national studies on LoS are required to understand the complex influence of different patient characteristics on clinical practice in the given contexts.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | European Psychiatry | ||||
| Publisher: | Cambridge University Press | ||||
| ISSN: | 0924-9338 | ||||
| Official Date: | February 2018 | ||||
| Dates: |
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| Volume: | 48 | ||||
| Number: | 1 | ||||
| Page Range: | pp. 6-12 | ||||
| DOI: | 10.1016/j.eurpsy.2017.11.001 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
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