PREDICTING LENGTH OF STAY IN PSYCHIATRY

Background. Diagnostic Related Groups (DRGs) and Healthcare Resource G roups (HRGs) do not predict accurately length of stay or resources nee ded for treatment in psychiatry. This preliminary study assessed the r elative contribution of severity of illness, in combination with other variables, in predicting length of stay. Method, Data were analysed o n 115 consecutive admissions to a district psychiatric in-patient unit to assess the variables which most accurately predict length of stay. The variables included demographic data, diagnosis, clinical, social and behavioural measures. Results, For initial admission, diagnosis of neurosis predicted shortest stay, but diagnosis alone accounted for o nly 14.6% of the variation in length of stay. Addition of Social Behav iour Scale score, living alone and specific psychiatric symptoms signi ficantly increased the predictive value (adjusted R-2 = 36.6%) Additio n of variables available at discharge (use of ECT, major tranquillizer s and antidepressants) significantly increased the adjusted R-2 to 49. 0%. Prediction of total length of hospitalization over a 12-month peri od, from the date of initial admission, indicated that mania predicted the longest stay and addition of other variables meant that only 18.9 % of length of stay was predicted. Conclusion, If these results are b orne out in a larger study, they indicate that diagnostic or health re lated groups (DRGs) are only likely to be useful in psychiatry if they include more detailed social, clinical and behavioural variables.