D. Yohanna et al., CHARACTERISTICS OF SHORT-STAY ADMISSIONS TO A PSYCHIATRIC INPATIENT SERVICE, JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH, 25(3), 1998, pp. 337-345
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.