Relationship Between Climate and Psychiatric Inpatient Length of Stay in Veterans Health Administration Hospitals

• Published in: The American journal of psychiatry 2000-10, Vol.157 (10), p.1669-1673
• Main Authors: Federman, Edward J., Drebing, Charles E., Boisvert, Charles, Penk, Walter, Binus, Gregory, Rosenheck, Robert
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Climate; Factor Analysis, Statistical; Health economics; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Hospitals, Veterans - statistics & numerical data; Humans; Inpatient care; Institution therapy. Inpatient treatment; Length of stay; Length of Stay - statistics & numerical data; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - therapy; Psychiatric Department, Hospital - statistics & numerical data; Psychiatric disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Seasons; Temperature; Treatments; United States - epidemiology; USA; Veterans
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.157.10.1669

OBJECTIVE: The study examined whether climate has an impact on inpatient psychiatric length of stay in Veterans Health Administration hospitals (VHA). METHOD: Data from the National Weather Service for eight climate variables for the locations of 134 VHA hospitals nationwide were factor analyzed, resulting in two climate factors representing temperature and precipitation. Factor scores were correlated with psychiatric mean lengths of stay from 1994 to 1998 for 99 VHA hospitals with inpatient psychiatric services and for the 22 VHA regional divisions (Veterans Integrated Service Networks). RESULTS: Climate factors correlated modestly but significantly with length of stay, with correlations ranging from -0.25 to -0.37 at the hospital level and from -0.38 to -0.45 at the VHA regional level; hospitals in warmer and drier climates had shorter lengths of stay. Medical centers in colder climates had the longest lengths of stay in winter and fall. The significant correlation between climate and length of stay was not affected by recent reductions in length of stay in VHA hospitals. CONCLUSIONS: Higher clinical costs associated with longer lengths of stay in colder climates have implications for budget planning. Climate factors must also be recognized for their potential effect on performance monitoring systems focused on hospital utilization. Researchers must continue to consider broader contextual variables such as climate if they are to fully understand the determinants of health care utilization and psychiatric hospitalization costs.