Comparative hospital tours. Visiting the oasis of psychiatry.

Aim: Currently, financial sponsors and Government officials of the relevant ministries responsible for the German health care system request comparati ve length-of-stay figures in hospitals as indicators of efficacy of inpatie nt treatment. In psychiatry such comparisons are considered doubtful becaus e of the heterogeneity of patients in different hospitals. This study compa res the length of stay in eight German psychiatric hospitals accounting for individual as well as organisational characteristics. Methods: Sample: 27,792 patient records according to the DGPPN-BADO (the st andardized psychiatric assessment and discharge battery in Germany) from ei ght hospitals with a total of 135 wards. Statistical Analysis: Variance com ponents modelling with random effects using three levels (patients, wards, hospitals). Results: After adjustment for patient and organisational characteristics, t here were no significant differences in the average length of stay between the eight hospitals. Conclusions: Hospital comparisons of quality of care require a multilevel a pproach. Based on our results further comparisons and implementation of qua lity improvements in inpatient psychiatry should focus on the ward level.