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Determinants of Length of Stay in a Psychiatric Ward: a Retrospective Chart Review

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Abstract

Considering the limited resources for providing inpatient services, identification of the factors influencing length of stay (LOS) is of great importance. The current study is a retrospective chart review which was planned to investigate the determinants of LOS in two gender-specific psychiatric wards within Baqiatallah Hospital (BQH) located in Tehran. The observation period was between March 21, 2011 and March 19, 2016. 3203 patients were recruited in terms of inclusion and exclusion criteria. Next, required data on 25 explanatory variables were extracted from their case-files. Descriptive measures were used for analysis and Independent Samples T-test, one-way ANOVA, Pearson’s correlation coefficient and Bonferroni’s post-hoc test for inferential analysis. Lastly, a multiple linear regression model was run to determine significant predictors of psychiatric LOS. Variables significantly correlated with patients’ LOS included gender, age, employment status, marital status, number of divorces, disability rate, discharge diagnosis, physical comorbidity, number of previous hospitalizations, suicide ideation, number of suicide attempts, history of assault, tobacco consumption, a history of narcotic drug abuse and number of ECT sessions. Through the analysis of multiple linear regression, it came to light that significant predictors of LOS in the final model could account for 37.9% of the variance in LOS. From the findings of current study, it can be inferred that clinical aspects as well as treatment procedures have major effects on LOS. Although the factors examined here could not explain an acceptable variance in LOS, the results are useful for the treatment team when they want to devise a care plan or give discharge to a patient.

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Acknowledgements

The authors would like to thank the staff of health information department in BQH for providing access to patients’ medical charts during a nine-month period. The authors are also grateful for the statistical counsels which Dr. Salesi generously offered. Finally, the authors appreciate the permission and guidance that the department for expanding clinical research in BQH provided.

Roles and Contributions

Dr. Noohi created the idea and devised the research plan. Then, she handled the correspondence for the official permission in order to conduct the study. Mr. Elikaei and Mr. Kalantari proceeded with the data collection. Dr. Noohi and Mr. Elikaei wrote the entire article and performed the statistical analyses. Dr. Hasanvandi reviewed the drafts and corrected the mistakes. Dr. Nouhi supervised the process from the beginning to the end. Mr. Elikaei submitted the article. He is the corresponding author.

Funding

The authors declare that they did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Associate Professor of Psychiatry, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Sima Noohi

  2. Freelance researcher, Tehran, Iran

    Siavash Kalantari & Mahdi Elikaei

  3. Assistant Professor, Department of Psychology, Faculty of Humanistic Sciences, Khorramabad Branch, Islamic Azad University, Khorramabad, Iran

    Saba Hasanvandi

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  1. Sima Noohi
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  4. Mahdi Elikaei
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Noohi, S., Kalantari, S., Hasanvandi, S. et al. Determinants of Length of Stay in a Psychiatric Ward: a Retrospective Chart Review. Psychiatr Q 91, 273–287 (2020). https://doi.org/10.1007/s11126-019-09699-0

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