Abstract

Background: Research on factors contributing to a patient’s length of stay on youth psychiatric inpatient units is relatively scarce and increasingly dated given changes in health care.

Objective: Hence, the current exploratory study attempts to take a step at identifying variables that are associated with length of stay for youth on an inpatient psychiatric unit in order to generate hypotheses for future larger-scale multisite research.

Method: A chart review was conducted on consecutive admissions to an academic medical center youth psychiatric inpatient service from September 2011 to June 2014. Analyses are for 1,201 consecutive admissions (M age = 13.37, SD = 2.79), who were predominantly African American (54.0%) and female (58.3%).

Results: Significant variables were entered into a hierarchical linear regression organized by variable category (i.e., patient characteristics, diagnostic/disease related, treatment-related characteristics, clinical caregiver characteristics, and characteristics or properties of the healthcare system). The final model accounted of 23% of the variance. Significant variables included insurance status, psychotic disorder, adjustment disorder, receiving pro re nata (PRN) medication for agitation during admission, being on a standing antipsychotic, change in attending from intake to discharge, presence of certain attendings during admission, and discharge to day hospital program or residential treatment center.

Conclusion: These variables provide provisional information suggesting that factors from multiple categories are related to length of stay including patient characteristics, diagnosis, treatment-related, clinical caregiver, and healthcare system. It is critical to take into account factors both internal and external to the child when developing an understanding of length of youth psychiatric hospitalization.

Keywords: Psychiatric inpatient, youth, length of stay, chart review, healthcare system, treatment-related characteristics.