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Prolonged length of stay in acute psychiatric wards: A descriptive study

Published online by Cambridge University Press:  13 August 2021

L. Lopes ,
M. Gonçalves-Pinho ,
S. Pereira ,
J.P. Ribeiro  and
A. Freitas
L. Lopes*
Affiliation:
Department Of Psychiatry And Mental Health, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
M. Gonçalves-Pinho
Affiliation:
Cintesis – Center For Health Technology And Services Research, Faculty of Medicine, University of Porto, Porto, Portugal Department Of Psychiatry And Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal, Penafiel, Portugal Department Of Community, Information And Health Decision Sciences (medcids), Faculty of Medicine, University of Porto, Porto, Portugal, Porto, Portugal
S. Pereira
Affiliation:
Department Of Psychiatry And Mental Health, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
J.P. Ribeiro
Affiliation:
Department Of Psychiatry And Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal, Penafiel, Portugal
A. Freitas
Affiliation:
Cintesis – Center For Health Technology And Services Research, Faculty of Medicine, University of Porto, Porto, Portugal Department Of Community, Information And Health Decision Sciences (medcids), Faculty of Medicine, University of Porto, Porto, Portugal, Porto, Portugal
*
*Corresponding author.

Abstract

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Introduction

The psychiatric care paradigm has shifted towards community-centered models. Yet, prolonged hospitalizations are still a reality, with debated impact at healthcare systems and patients.

Objectives

This work aims to describe prolonged hospitalizations in acute psychiatric wards through patients’ sociodemographic and clinical data.

Methods

We analyzed a national hospitalization database that contained all hospitalization episodes registered in Portuguese public hospitals from 2008 to 2015. All episodes with a primary diagnosis of mental disorder defined as ICD-9-CM codes 290.x-319.x were included. Prolonged hospitalizations were defined as having a LoS ≥ P97.5; LOS ≥180 days or LOS ≥1 year. Age, sex, lengh of stay, in-hospital mortality were analysed.

Results

The LoS ≥ P97.5(≥62 days) group comprised 3911 hospitalizations (2.3% of all psychiatric hospitalizations) and 1755 patients. The median LOS was 81 days and the mean age was 51 years. Sex was equally distributed, though a higher frequency of male patients was found on the ≥180 days (n=364) and ≥ 1 year (n=121) groups. Psychotic disorders were the main diagnosis at discharge (n= 1769, 45.2%), followed by mood disorders (n=1057, 27.0%) and dementia (n=451, 11.5%). In-hospital mortality increased in the higher LoS groups (1.1%; 4.4%; 9.1%, respectively).

Conclusions

Overall, middle aged patients with psychotic disorders represent most of the prolonged hospitalizations occurring in acute psychiatric wards. Community-based programs require further development to meet the existing needs.

Disclosure

No significant relationships.

Keywords

length of stayAdministrative Databasepsychiatric hospitalsHealthcare utilization
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S121 - S122
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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