Investigating Medical Predictors of Extended Length of Stay Among
Psychiatric Inpatients
Abstract
Objective. Extended length of stay (eLOS) has been contributing
to the reduction of hospital resources and patient satisfaction in
inpatient psychiatry. With the mean LOS in psychiatry being almost twice
the length of other medical conditions, our study aims to identify
factors that are associated with eLOS in order to make quality
improvements. Methods. This was a retrospective, observational
study. A total of 17,257 patients admitted into the inpatient psychiatry
unit at Queen’s Medical Center between January 2019 and December 2023 in
Honolulu, Hawaii were included in this analysis. Descriptive analysis
was used to identify associations of eLOS between various clinical and
demographic variables. Results. The strongest sociodemographic
predictors of LOS came from: sex (p=0.005), age (p=<0.0001),
employment (p=<0.0001), race (p=<0.0001), marital status
(p=0.03), homelessness (p=0.006), and having access to Medicaid and/or
Medicare (p=<0.0001). The following clinical predictors revealed
a strong relationship with LOS: establishment of a PCP
(p=<0.0001), diagnosis of intellectual disability (p=0.002), low
CSSRS (p=<0.0001), the non-use of illicit drugs, cannabis,
ethanol, and the rising number of prescribed psychotherapeutics per
patient (p=<0.0001). Conclusion. Identifying strong
predictors of eLOS in the United States still remains
under-investigated. Enhancing our understanding about factors associated
with eLOS will lead to improved treatment planning and resource
allocation for inpatient psychiatric hospitalization.