Cargando…
Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward
PURPOSE: To evaluate the longest hospitalizations in an acute psychiatric ward [Service of Psychiatric Diagnosis and Treatment (SPDT)] and the related demographic, clinical and organizational variables to understand the factors that contribute to long-stay (LOS) phenomenon. The term “long stay” indi...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245472/ https://www.ncbi.nlm.nih.gov/pubmed/32547274 http://dx.doi.org/10.2147/RMHP.S238741 |
_version_ | 1783537767269007360 |
---|---|
author | Di Lorenzo, Rosaria Montardi, Giulia Panza, Leda Del Giovane, Cinzia Saraceni, Serena Rovesti, Sergio Ferri, Paola |
author_facet | Di Lorenzo, Rosaria Montardi, Giulia Panza, Leda Del Giovane, Cinzia Saraceni, Serena Rovesti, Sergio Ferri, Paola |
author_sort | Di Lorenzo, Rosaria |
collection | PubMed |
description | PURPOSE: To evaluate the longest hospitalizations in an acute psychiatric ward [Service of Psychiatric Diagnosis and Treatment (SPDT)] and the related demographic, clinical and organizational variables to understand the factors that contribute to long-stay (LOS) phenomenon. The term “long stay” indicates clinical, social and organizational problems responsible for delayed discharges. In psychiatry, clinical severity, social dysfunction and/or health-care system organization appear relevant factors in prolonging stays. PATIENTS AND METHODS: We divided all the SPDT hospitalizations from 1 January 2010 to 31 December 2015 into two groups based on the 97.5(th) percentile of duration: ≤36 day (n=3254) and >36 day (n=81) stays, in order to compare the two groups for the selected variables. Comparisons were made using Pearson’s chi-square for categorical data and t-test for continuous variables, the correlation between the LOS, as a dependent variable, and the selected variables was analyzed in stepwise multiple linear regression and in multiple logistic regression models. RESULTS: The longest hospitalizations were significantly related to the diagnosis of “schizophrenia and other psychosis” (Pearson Chi(2)=17.24; p=0.045), the presence of moderate and severe aggressiveness (Pearson chi(2)=29; p=0.000), compulsory treatment (Pearson Chi(2)=8.05; p=0.005), parenteral or other route administration of psycho-pharmacotherapy (Pearson Chi(2)=12.91; p=0.007), poli-therapy (Pearson Chi(2)=6.40; p=0.041), complex psychiatric activities (Pearson Chi(2)=12.26; p=0.002) and rehabilitative programs (Pearson Chi(2)=37.05; p=0.000) during the hospitalization and at discharge (Pearson Chi(2)=29.89; p=0.000). Many demographic and clinical variables were statistically significantly correlated to the LOS at our multiple linear and logistic regression model. CONCLUSION: In our sample, clinical illness severity and need for complex therapeutic and rehabilitative treatments were associated with prolonged psychiatric hospitalizations. Understanding this phenomenon can have not only economic but also clinical, ethical and social relevance. |
format | Online Article Text |
id | pubmed-7245472 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-72454722020-06-15 Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward Di Lorenzo, Rosaria Montardi, Giulia Panza, Leda Del Giovane, Cinzia Saraceni, Serena Rovesti, Sergio Ferri, Paola Risk Manag Healthc Policy Original Research PURPOSE: To evaluate the longest hospitalizations in an acute psychiatric ward [Service of Psychiatric Diagnosis and Treatment (SPDT)] and the related demographic, clinical and organizational variables to understand the factors that contribute to long-stay (LOS) phenomenon. The term “long stay” indicates clinical, social and organizational problems responsible for delayed discharges. In psychiatry, clinical severity, social dysfunction and/or health-care system organization appear relevant factors in prolonging stays. PATIENTS AND METHODS: We divided all the SPDT hospitalizations from 1 January 2010 to 31 December 2015 into two groups based on the 97.5(th) percentile of duration: ≤36 day (n=3254) and >36 day (n=81) stays, in order to compare the two groups for the selected variables. Comparisons were made using Pearson’s chi-square for categorical data and t-test for continuous variables, the correlation between the LOS, as a dependent variable, and the selected variables was analyzed in stepwise multiple linear regression and in multiple logistic regression models. RESULTS: The longest hospitalizations were significantly related to the diagnosis of “schizophrenia and other psychosis” (Pearson Chi(2)=17.24; p=0.045), the presence of moderate and severe aggressiveness (Pearson chi(2)=29; p=0.000), compulsory treatment (Pearson Chi(2)=8.05; p=0.005), parenteral or other route administration of psycho-pharmacotherapy (Pearson Chi(2)=12.91; p=0.007), poli-therapy (Pearson Chi(2)=6.40; p=0.041), complex psychiatric activities (Pearson Chi(2)=12.26; p=0.002) and rehabilitative programs (Pearson Chi(2)=37.05; p=0.000) during the hospitalization and at discharge (Pearson Chi(2)=29.89; p=0.000). Many demographic and clinical variables were statistically significantly correlated to the LOS at our multiple linear and logistic regression model. CONCLUSION: In our sample, clinical illness severity and need for complex therapeutic and rehabilitative treatments were associated with prolonged psychiatric hospitalizations. Understanding this phenomenon can have not only economic but also clinical, ethical and social relevance. Dove 2020-05-19 /pmc/articles/PMC7245472/ /pubmed/32547274 http://dx.doi.org/10.2147/RMHP.S238741 Text en © 2020 Di Lorenzo et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Di Lorenzo, Rosaria Montardi, Giulia Panza, Leda Del Giovane, Cinzia Saraceni, Serena Rovesti, Sergio Ferri, Paola Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward |
title | Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward |
title_full | Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward |
title_fullStr | Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward |
title_full_unstemmed | Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward |
title_short | Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward |
title_sort | retrospective analysis of factors associated with long-stay hospitalizations in an acute psychiatric ward |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245472/ https://www.ncbi.nlm.nih.gov/pubmed/32547274 http://dx.doi.org/10.2147/RMHP.S238741 |
work_keys_str_mv | AT dilorenzorosaria retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward AT montardigiulia retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward AT panzaleda retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward AT delgiovanecinzia retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward AT saraceniserena retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward AT rovestisergio retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward AT ferripaola retrospectiveanalysisoffactorsassociatedwithlongstayhospitalizationsinanacutepsychiatricward |