Abstract
The average length of inpatient stay (LOS) for psychiatric care has declined substantially across Canada and the United States during the past two decades. Although LOS is based presumably on patient, hospital, and community factors, there is little understanding of how such factors are linked with LOS. The purpose of this study was to explore potential individual and systemic factors associated with LOS in a large-scale, longitudinal dataset. Study participants consisted of individuals 11 years of age and older admitted for psychiatric conditions to a New Brunswick hospital between April 1, 2003 and March 31, 2014 (N = 51,865). The study used a retrospective cohort design examining data from the New Brunswick Discharge Abstract Database, administrative data comprised of all inpatient admissions across provincial hospitals. Hierarchical regression analysis was used to estimate the association of individual, facility, and system-level factors with psychiatric LOS. Results indicated that hospital-level factors and individual-level characteristics (i.e., discharge disposition, aftercare referral, socioeconomic status (SES)) account for significant variability in LOS. Consistent with extant literature, our results found that hospital, clinical, and individual factors together are associated with LOS. Furthermore, our results highlight demographic factors surrounding living situation and available financial supports, as well as the match or mismatch between preferred language and language in which services are offered.
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Acknowledgements
The authors would like to acknowledge the collective intellectual contribution of the ACCESS Mental Health research project investigators, the Canadian Institutes of Health Research, the Maritime SPOR SUPPORT Unit, and the New Brunswick Health Research Foundation. In addition, this work was supported by the Department of Health of the Province of New Brunswick under a contract with the New Brunswick Institute for Research, Data, and Training at the University of New Brunswick. The results and conclusions are those of the authors and no official endorsement by the government of New Brunswick was intended or should be inferred.
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This manuscript describes original work supported by grants from the University of New Brunswick and the Canadian Institutes of Health Research (Grant No. TT4-128269). We do not have any conflict of interest in submitting this work. We, the authors, acknowledge that disclosures are complete for ourselves as well as our co-authors, to the best of our knowledge. All authors contributed to the study conception and design. Material preparation, data acquisition, data cleaning, and analysis were performed by David Miller, Dr. Scott Ronis, and Dr. Amanda Slaunwhite. The first draft of the manuscript was written by David Miller and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Miller, D.A.A., Ronis, S.T. & Slaunwhite, A.K. The Impact of Demographic, Clinical, and Institutional Factors on Psychiatric Inpatient Length-of-Stay. Adm Policy Ment Health 48, 683–694 (2021). https://doi.org/10.1007/s10488-020-01104-4
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DOI: https://doi.org/10.1007/s10488-020-01104-4