Social factors in psychiatric length of stay among youths discharged from general hospitals.

Abstract

Length of hospital stay for psychiatric care is thought to be a product of social factors as well as diagnostic and treatment-related variables. Social factors include characteristics of hospitals and the financial, legal, and social resources of patients and their families. This study compared the role of social factors in determining the length of psychiatric hospitalization among adolescent and young adult patients (ages 12 to 22) who were discharged from general hospitals throughout the United States during 1987. Data representing over 40,000 episodes of inpatient treatment were randomly split into two samples. A multiple regression model of length of hospital stay was derived using data from the first sample and cross-validated with data from the second sample. The results included statistically significant findings that supported the initial research hypotheses, but social factors appeared to have little influence on psychiatric lengths of stay once diagnoses and other clinically-related variables were included in the model. Given other evidence that social factors influence patterns of inpatient treatment, the results suggest that such effects may be found in the rate of hospital admissions rather than the length of hospital stay. The study indicates that future efforts to reduce inappropriate psychiatric hospitalizations should focus on admissions rather than patient length of stay.