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Determinants of length of stay for psychiatric inpatients: Analysis of a national database covering the entire Korean elderly population

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  • Chung, Woojin
  • Oh, Sun-Min
  • Suh, Tongwoo
  • Lee, Young Moon
  • Oh, Byoung Hoon
  • Yoon, Chung-Won
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    Abstract

    Objective In a rapidly aging society, inappropriately long geropsychiatric inpatient hospitalization is a challenging concern for mental health policy-makers and researchers. This study aimed to investigate patient and institutional factors affecting geropsychiatric inpatient length of stay (LOS), providing an overview of current geropsychiatric health care system in South Korea.Methods This retrospective, population-based, cross-sectional study analysed nationwide reimbursement claim databases covering the entire elderly population of Korea between January 2005 and June 2006. Given the nested structure of the data, a multivariate multilevel regression analysis was performed.Results The average LOS was 128 days. Males, patients with schizophrenia, and those enrolled in a National Medical Care Aid program tended to have longer hospital stays. Patient age was negatively related to LOS. Institutional variables related to longer hospitalizations included a psychiatric hospital, a higher number of beds, fewer human resource employees, a higher proportion of male, oldest old, and patients with dementia.Conclusions Our results suggest that policies targeting geropsychiatric patients diagnosed with schizophrenia, enrolled in National Medical Care Aid programs, and admitted to psychiatric hospitals could reduce LOS. Additionally, the impact of the patient composition of a medical institution on LOS needs to be closely investigated.

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 94 (2010)
    Issue (Month): 2 (February)
    Pages: 120-128

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    Handle: RePEc:eee:hepoli:v:94:y:2010:i:2:p:120-128

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    Web page: http://www.elsevier.com/locate/healthpol

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    Keywords: Length of stay Geriatric psychiatry Hospitalization Mental health services Korea;

    References

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    1. Chung, Woojin & Cho, Woo Hyun & Yoon, Chung Won, 2009. "The influence of institutional characteristics on length of stay for psychiatric patients: A national database study in South Korea," Social Science & Medicine, Elsevier, vol. 68(6), pages 1137-1144, March.
    2. Imai, Hirohisa & Hosomi, Jun & Nakao, Hiroyuki & Tsukino, Hiromasa & Katoh, Takahiko & Itoh, Toshihiro & Yoshida, Takahiko, 2005. "Characteristics of psychiatric hospitals associated with length of stay in Japan," Health Policy, Elsevier, vol. 74(2), pages 115-121, October.
    3. Richard G. Wight & Janet R. Cummings & Arun S. Karlamangla & Carol S. Aneshensel, 2009. "Urban Neighborhood Context and Change in Depressive Symptoms in Late Life," Journals of Gerontology: Series B, Gerontological Society of America, vol. 64(2), pages 247-251.
    4. Silver, Eric & Mulvey, Edward P. & Swanson, Jeffrey W., 2002. "Neighborhood structural characteristics and mental disorder: Faris and Dunham revisited," Social Science & Medicine, Elsevier, vol. 55(8), pages 1457-1470, October.
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    Cited by:
    1. Masayoshi Hayashi, 2011. "The effects of medical factors on transfer deficits in Public Assistance in Japan: a quantile regression analysis," International Journal of Health Care Finance and Economics, Springer, vol. 11(4), pages 287-307, December.

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