Predicting Time-to-Independent-Release from Current Level of Functioning for Psychiatric Inpatients: A “Survivor” Analysis

Non-optimal psychiatric discharges occur frequently and result in high costs. The Time-Sample Behavioral Checklist (TSBC) has been demonstrated to be the best method for determining successful independent discharge within 2 weeks of assessment for adult inpatients. This study examined the extent to...

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Bibliographic Details
Published in:The journal of behavioral health services & research 2008-07, Vol.35 (3), p.315-333
Main Authors: Springer, Justin R., Paul, Gordon L.
Format: Article
Language:English
Subjects:
Adult
Community and Environmental Psychology
Dangerous Behavior
Dangerousness
Discharge
Discharged
Female
Health Informatics
Health Promotion and Disease Prevention
Health Psychology
Hospitals, Psychiatric - standards
Humans
Inpatients
Length of Stay
Male
Medicine
Medicine & Public Health
Mental Disorders - diagnosis
Mental health care
Middle Aged
Patient Discharge - standards
Patient Readmission
Psychiatric hospitals
Psychiatry
Public Health
Readiness
Regression analysis
Regular Article
Studies
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Summary:Non-optimal psychiatric discharges occur frequently and result in high costs. The Time-Sample Behavioral Checklist (TSBC) has been demonstrated to be the best method for determining successful independent discharge within 2 weeks of assessment for adult inpatients. This study examined the extent to which TSBC indexes and perceived dangerousness predict staff independent discharge-readiness judgments up to 6 months after initial assessment. Data from 22 acute and chronic/mixed units ( N  = 362) were analyzed using Cox proportional hazard regression. TSBC appropriate interpersonal interaction and appropriate behavior variability predicted shorter time-to-independent-release (TTIR). TSBC bizarre facial expressions and verbalizations predicted longer TTIR. Post hoc analyses suggest that acutely admitted inpatients perceived to be dangerous were discharged sooner than others—a finding that is likely attributable to differential psychotropic medication responsiveness. Implications are discussed for TSBC implementation for earlier identification of discharge-ready inpatients and for tailoring interventions to target behavior that predicts independent discharge success.
ISSN:1094-3412
1556-3308
DOI:10.1007/s11414-007-9096-9