tailieunhanh - Báo cáo y học: " Does psychopathology at admission predict the length of inpatient stay in psychiatry? Implications for financing psychiatric services"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Does psychopathology at admission predict the length of inpatient stay in psychiatry? Implications for financing psychiatric services | Warnke et al. BMC Psychiatry 2011 11 120 http 1471 -244X 11 120 BMC Psychiatry RESEARCH ARTICLE Open Access Does psychopathology at admission predict the length of inpatient stay in psychiatry Implications for financing psychiatric services Ingeborg Warnke Wulf Rossler and Uwe Herwig Abstract Background The debate on appropriate financing systems in inpatient psychiatry is ongoing. In this context it is important to control resource use in terms of length of stay LOS which is the most costly factor in inpatient care and the one that can be influenced most easily. Previous studies have shown that psychiatric diagnoses provide only limited justification for explaining variation in LOS and it has been suggested that measures such as psychopathology might be more appropriate to predict resource use. Therefore we investigated the relationship between LOS and psychopathological syndromes or symptoms at admission as well as other characteristics such as sociodemographic and clinical variables. Methods We considered routine medical data of patients admitted to the Psychiatric University Hospital Zurich in the years 2008 and 2009. Complete data on psychopathology at hospital admission were available in 3 220 inpatient episodes. A subsample of 2 939 inpatient episodes was considered in final statistical models including psychopathology as well as complete datasets of further measures . sociodemographic clinical treatment-related and psychosocial variables . We used multivariate linear as well as logistic regression analysis with forward selection procedure to determine the predictors of LOS. Results All but two syndrome scores mania hostility were positively related to the length of stay. Final statistical models showed that syndromes or symptoms explained about 5 of the variation in length of stay. The inclusion of syndromes or symptoms as well as basic treatment variables and other factors led to an explained variation of up to 25 . Conclusions .