Administration and Policy in Mental Health and Mental Health Services Research

, Volume 38, Issue 3, pp 155–168

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

Original Paper

DOI: 10.1007/s10488-010-0310-3

Cite this article as:
Tulloch, A.D., Fearon, P. & David, A.S. Adm Policy Ment Health (2011) 38: 155. doi:10.1007/s10488-010-0310-3


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.


Length of stayPsychiatric hospitalsHealthcare utilization

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Alex D. Tulloch
    • 1
  • Paul Fearon
    • 1
    • 2
  • Anthony S. David
    • 1
  1. 1.Department of Psychiatry, Institute of PsychiatryKings College LondonLondonUK
  2. 2.Trinity College Dublin and St Patrick’s University Hospital DublinDublin 8Ireland