Decreasing Length of Stay: Are There Effects on Outcomes of Psychiatric Hospitalization?

OBJECTIVE: The authors compared hospital outcomes for depressed patients hospitalized between 1988 and 1996. METHOD: Between 1988 and 1996, 206 depressed patients in three cohorts were evaluated at admission; of these, 161 (78.2%) were evaluated at discharge and 119 (78.3% of those followed [N=152])...

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Published in:The American journal of psychiatry 1998-07, Vol.155 (7), p.905-909
Main Authors: Lieberman, Paul B., Wiitala, Stephen A., Elliott, Binette, McCormick, Sandra, Goyette, Stephanie B.
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Ambulatory Care - statistics & numerical data
Biological and medical sciences
Depression
Depressive Disorder - diagnosis
Depressive Disorder - psychology
Depressive Disorder - therapy
Factors
Female
Follow-Up Studies
Health care
Hospitalization - statistics & numerical data
Humans
Length of Stay
Male
Medical sciences
Mental depression
Middle Aged
Mood disorders
Outcomes
Patient Readmission
Patients
Psychiatric hospitals
Psychiatric Status Rating Scales
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reduction
Treatment Outcome
USA
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Summary:OBJECTIVE: The authors compared hospital outcomes for depressed patients hospitalized between 1988 and 1996. METHOD: Between 1988 and 1996, 206 depressed patients in three cohorts were evaluated at admission; of these, 161 (78.2%) were evaluated at discharge and 119 (78.3% of those followed [N=152]) 1 month later. Evaluation consisted of measures of symptoms, global functioning, self-concept, ego defenses, work and social functioning, and readmission. RESULTS: Lengths of stay significantly declined over time (26.5 versus 19.5 versus 8.3 days). At discharge, the most recently hospitalized group showed higher residual depression and lower residual global functioning scores than the other groups. Other measures did not differ among the groups at discharge. One month after discharge, the shortest-stay group continued to show lower global functioning, as well as lower quantity of work functioning. Readmission rates were equal. Within the shortest-stay group, no differences in outcome were found between patients treated in a partial hospital and those not so treated. CONCLUSIONS: Improvement during very brief admission is comparable to that in longer stays on many aspects of functioning. However, depressed patients discharged more quickly show significantly higher residual levels of depressive symptoms and lower levels of global functioning, which may place them at greater risk for adverse outcomes in the immediate posthospital period. (Am J Psychiatry 1998; 155:905-909)
ISSN:0002-953X
1535-7228
DOI:10.1176/ajp.155.7.905