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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...

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Autores principales: Di Lorenzo, Rosaria, Montardi, Giulia, Panza, Leda, Del Giovane, Cinzia, Saraceni, Serena, Rovesti, Sergio, Ferri, Paola
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
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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.
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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
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