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Characteristics of short-stay admissions to a psychiatric inpatient service

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Abstract

Since the rapid expansion of managed care coupled with dramatic reductions in lengths of inpatient stays, there is widespread concern that the emphasis on cost containment is eclipsing attention to patient care. The present study was undertaken to evaluate speculations that the majority of short-stay (less than 48 hours) admissions to a psychiatric inpatient service at a large teaching hospital in the midwestern United States consisted of public pay patients who were rapidly transferred to area state hospitals. Using two case mix measures, severity of illness and changes in acuity and clinical outcomes of a sample of short-stay (n = 77) and longer stay (n = 145) admissions were compared. Short-stay admissions, although similar to longer stay patients in terms of demographics, Axis I diagnosis, payer status, and appropriateness of admission, are clinically distinct. The use of nonhospital alternatives in treating a subsample of suicidal patients and the implications for improved mental health service delivery are discussed.

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Authors and Affiliations

  1. Northwestern University Medical School, 303 East Superior, 60611, Chicago, IL

    Daniel Yohanna M.D. (Assistant Professor of Psychiatry)

  2. Mental Health Services and Policy Program, Northwestern University Medical School, Chicago, Illinois

    Nina J. Christopher B.A., John S. Lyons Ph.D. (director) & Marcia Slomowitz M.D. (director of inpatient psychiatry)

  3. Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, Illinois

    Sheldon I. Miller M.D. (chairman and Lizzie Gilman Professor of Psychiatry)

  4. Norman and Ida Stone Institute of Psychiatry, Northwestern Memorial Hospital, USA

    Marcia Slomowitz M.D. (director of inpatient psychiatry) & Janice K. Bultema M.S.N., R.N., C.N.A.A. (director of skilled nursing and interim director)

  5. Department of Community, Mental Health, and Administrative Nursing, Marcella Niehoff School of Nursing, Loyola University, Chicago, Illinois

    Janice K. Bultema M.S.N., R.N., C.N.A.A. (director of skilled nursing and interim director)

Authors
  1. Daniel Yohanna M.D.
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  2. Nina J. Christopher B.A.
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  3. John S. Lyons Ph.D.
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  4. Sheldon I. Miller M.D.
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  5. Marcia Slomowitz M.D.
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  6. Janice K. Bultema M.S.N., R.N., C.N.A.A.
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Correspondence to Daniel Yohanna M.D..

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Yohanna, D., Christopher, N.J., Lyons, J.S. et al. Characteristics of short-stay admissions to a psychiatric inpatient service. The Journal of Behavioral Health Services & Research 25, 337–345 (1998). https://doi.org/10.1007/BF02287472

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