Skip to main content
SpringerLink
Log in

The Dynamics of Psychiatric Bed Use in General Hospitals

  • Original Article
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

This study examines general hospitals’ adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N = 7,831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100 % occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Agency for Healthcare Research and Quality (2013a). Overview of the nationwide inpatient sample (NIS), healthcare cost and utilization project (HCUP). from www.hcup-us.ahrq.gov/nisoverview.jsp. Retrieved 11 Nov 2013.

  • Agency for Healthcare Research and Quality (2013b). HCUP clinical classifications software (CCS) for ICD-9-CM, healthcare cost and utilization project (HCUP). from www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp. Retrieved 11 Nov 2013.

  • Alakeson, V., Pande, N., & Ludwig, M. (2010). A plan to reduce emergency room ‘boarding’ of psychiatric patients. Health Affairs, 29(9), 1637–1642.

    Article  PubMed  Google Scholar 

  • American College of Emergency Physicians (2008). ACEP psychiatric and substance abuse survey 2008. from http://www.acep.org/uploadedFiles/ACEP/Advocacy/federal_issues/PsychiatricBoardingSummary.pdf. Retrieved 1 May 2009.

  • Baraff, L. J., Janowicz, N., & Asarnow, J. R. (2006). Survey of California emergency departments about practices for management of suicidal patients and resources available for their care. Annals of Emergency Medicine, 48(4), 452–458.

    Article  PubMed  Google Scholar 

  • Brenner, M. H. (1967). Economic change and mental hospitalization: New York State, 1910–1960. Social Psychiatry, 2(4), 180–188.

    Article  Google Scholar 

  • Catalano, R., & Hartig, T. (2004). Economic predictors of admissions to inpatient psychiatric treatment in sweden. Social Psychiatry and Psychiatric Epidemiology, 39(4), 305–310.

    Article  PubMed  Google Scholar 

  • Chang, G., Weiss, A. P., Orav, E. J., Smallwood, J. A., Gonzalez, S., Kosowsky, J. M., et al. (2012). Bottlenecks in the Emergency Department: the psychiatric clinicians’ perspective. General Hospital Psychiatry, 34, 403–409.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hausman, J. A. (1978). Specification tests in econometrics. Econometrica, 46, 1251–1271.

    Article  Google Scholar 

  • Lamb, H. R., & Weinberger, L. E. (2005). The shift of psychiatric inpatient care from hospitals to jails and prisons. Journal of the American Academy of Psychiatry Law, 33, 529–534.

    Google Scholar 

  • Mark, T., Vandivort-Warren, R., Owens, P., Buck, J., Levit, K., Coffey, R., et al. (2010). Psychiatric discharges in community hospitals with and without psychiatric units: How many and for whom?. Psychiatric Services, 61(6), 562–568.

    Article  PubMed  Google Scholar 

  • National Center for Health Statistics (2012) Health, United States, 2011: Table 117. Mental health organizations and beds for 24-hour hospital and residential treatment, by type of organization. Hyattsville, MD. http://www.cdc.gov/nchs/hus/contents2011.htm#117. Accessed 4 Sept 2013.

  • Sharfstein, S. S., & Dickerson, F. B. (2009). Hospital psychiatry for the twenty-first century. Health Affairs, 28(3), 685–688.

    Article  PubMed  Google Scholar 

  • Shumway, M., Alvidrez, J., Leary, M., Sherwood, D., Woodard, E., Lee, E. K., et al. (2012). Impact of capacity reductions in acute public-sector inpatient psychiatric services. Psychiatric Services, 63(2), 135–141.

    Article  PubMed  Google Scholar 

  • Slade, E. P., Dixon, L. B., & Semmel, S. (2010). Trends in the duration of emergency department visits, 2001–2006. Psychiatric Services, 61(9), 878.

    PubMed  Google Scholar 

  • Torrey, E. F., Entsminger, K., Geller, J., Stanley, J., & Jaffe, D. J. (2008). The shortage of public hospital beds for mentally ill persons. Arlington, VA: Treatment Advocacy Center.

    Google Scholar 

  • Unick, G. J., Kessell, E., Woodard, E. K., Leary, M., Dilley, J. W., & Shumway, M. (2011). Factors affecting psychiatric inpatient hospitalization from a psychiatric emergency service. General Hospital Psychiatry, 33(6), 618–625.

    Article  PubMed  Google Scholar 

  • Wooldridge, J. M. (2002). Econometric analysis of cross section and panel data. Cambridge, MA: The MIT Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. U.S. Department of Veterans Affairs, VA Capitol Healthcare Network Mental Illness Research, Education, and Clinical Center, 10 N. Greene Street, Baltimore, MD, 21201, USA

    Eric P. Slade

  2. Department of Psychiatry, University of Maryland School of Medicine, 737 W. Lombard Street, Baltimore, MD, 21227, USA

    Eric P. Slade & Howard H. Goldman

Authors
  1. Eric P. Slade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Howard H. Goldman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric P. Slade.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Slade, E.P., Goldman, H.H. The Dynamics of Psychiatric Bed Use in General Hospitals. Adm Policy Ment Health 42, 139–146 (2015). https://doi.org/10.1007/s10488-014-0554-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-014-0554-4

Keywords

Search

Navigation