TY - JOUR
TI - Factors affecting hospital stay in psychiatric patients: the role of
active comorbidity
AU - Douzenis, Athanassios
AU - Seretis, Dionysios
AU - Nika, Stella and
AU - Nikolaidou, Paraskevi
AU - Papadopoulou, Athanassia
AU - Rizos, Emmanouil
AU - N.
AU - Christodoulou, Christos
AU - Tsopelas, Christos
AU - Mitchell,
AU - Dominic
AU - Lykouras, Lefteris
JO - BMC Health Services Research
PY - 2012
VL - 12
TODO - null
SP - null
PB - BMC
SN - 1472-6963
TODO - 10.1186/1472-6963-12-166
TODO - Bipolar; Schizophrenia; Referral; Hospital stay; Physical comorbidity
TODO - Background: Research on length of stay (LOS) of psychiatric inpatients
is an under-investigated issue. In this naturalistic study factors which
affect LOS of two groups of patients were investigated, focusing on the
impact on LOS of medical comorbidity severe enough to require referral.
Methods: Active medical comorbidity was quantified using referral as the
criterion. The study sample consisted of 200 inpatients with the
diagnosis of schizophrenia and 228 inpatients suffering from bipolar
disorder (type I or II). Jonckheere and Mann-Whitney tests were used to
estimate the influence of referrals on LOS, and regression analyses
isolated variables associated with LOS separately for each group.
Results: Half of the patients needed one or more referrals for a
non-psychiatric problem. The most common medical condition of patients
with bipolar disorder was arterial hypertension. Inpatients with
schizophrenia suffered mostly from an endocrine/metabolic disease - 12%
of referrals were for Hashimoto’s thyroiditis. A positive linear trend
was found between LOS and number of referrals; the effect was greater
for schizophrenia patients. The effect of referrals on LOS was verified
by regression in both groups. Overall, referred patients showed greater
improvement in GAF compared to controls.
Conclusions: To our knowledge this was the first study to investigate
physical comorbidity in psychiatric inpatients using the criterion of
referral to medical subspecialties. Comorbidity severe enough to warrant
referral is a significant determinant of hospital stay. This insight may
prove useful in health care planning. The results show lack of effective
community care in the case of schizophrenia and negative symptoms may be
the cause of this. Our findings call for more attention to be paid to
the general medical needs of inpatients with severe mental health and
concurrent severe medical comorbidity.
ER -