DECREASING LENGTH OF STAY - ARE THERE EFFECTS ON OUTCOMES OF PSYCHIATRIC-HOSPITALIZATION

Objective: The authors compared hospital outcomes for depressed patien ts hospitalized between 1988 and 1996. Method: Between 1988 and 1996, 206 depressed patients in three cohorts were evaluated at admission; o f these, 161 (78.2%) were evaluated at discharge and 119 (78.3% of tho se followed [N=152]) 1 month later. Evaluation consisted of measures o f symptoms, global functioning, self-concept, ego defenses, work and s ocial functioning, and readmission. Results: Lengths of stay significa ntly declined over time (26.5 versus 19.5 versus 8.3 days). At dischar ge, the most recently hospitalized group showed higher residual depres sion and lower residual global functioning scores than the other group s. Other measures did not differ among the groups at discharge. One mo nth after discharge, the shortest-stay group continued to show lower g lobal functioning, as well as lower quantity of work functioning. Read mission rates were equal. Within the shortest-stay group, no differenc es in outcome were found between patients treated in a partial hospita l and those not so treated. Conclusions: Improvement during very brief admission is comparable to that in longer stays on many aspects of fu nctioning. However, depressed patients discharged move quickly show si gnificantly higher residual levels of depressive symptoms and lower le vels of global functioning, which may place them at greater risk for a dverse outcomes in the immediate posthospital period.