CHARACTERISTICS OF SHORT-STAY ADMISSIONS TO A PSYCHIATRIC INPATIENT SERVICE

Since the rapid expansion of managed care coupled with dramatic reduct ions in lengths of inpatient stays, there is widespread concern that t he emphasis on cost containment is eclipsing attention to patient care . The present study was undertaken to evaluate speculations that the m ajority of short-stay (less than 48 hours) admissions to a psychiatric inpatient service at a large teaching hospital in the midwestern Unit ed States consisted of public pay patients who were rapidly transferre d to area state hospitals. Using two case mix measures, severity of il lness and changes in acuity and clinical outcomes of a sample of short -stay (n = 77) and longer stay (n = 145) admissions were compared. Sho rt-stay admissions, although similar to longer stay patients in terms of demographics, Axis I diagnosis, payer status, and appropriateness o f admission, are clinically distinct. The use of nonhospital alternati ves in treating a subsample of suicidal patients and the implications for improved mental health service delivery are discussed.