Assessing predictive factors for extended hospitalization at acute psychiatric admission

Objective: This study examined whether information obtained early in the ho spitalization process can be used to assess a patients need for extended ca re. Methods: A sample of 2,430 inpatients who were admitted to a state psyc hiatric facility during a one-year index period (January through December 1 997) were randomly assigned to a primary sample or a replication sample. Da ta were collected on demographic characteristics and history of previous ho spitalization. The Brief Psychiatric Rating Scale-Anchored Version (BPRS-A) was administered to patients within 48 hours of admission, and four new su bscales derived from ratings of newly admitted patients were calculated. Un ivariate and multivariate analyses were conducted to identify factors assoc iated with whether a patient was discharged to the community or transported to another hospital for extended care. Results: A discriminant analysis of the data correctly identified 70 percent of the patients who were referred for continued hospitalization and 80 percent of the patients who were disc harged to the community. The main correlates of the need for extended inpat ient services were, in descending order, scores on the BPRS-A resistance su bscale, the number of previous referrals for extended hospitalizations, and scores on the BPRS-A positive symptoms and psychological discomfort scales . Conclusions: BPRS-A subscale scores should be considered to be at least a s good as more traditional measures in predicting length of hospitalization .