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BMC Health Services Research

, 12:166

First Online: 19 June 2012Received: 04 December 2011Accepted: 11 April 2012DOI: 10.1186-1472-6963-12-166

Cite this article as: Douzenis, A., Seretis, D., Nika, S. et al. BMC Health Serv Res 2012 12: 166. doi:10.1186-1472-6963-12-166

Abstract

BackgroundResearch on length of stay LOS of psychiatric inpatients is an under-investigated issue. In this naturalistic study factors which affect LOS of two groups of patients were investigated, focusing on the impact on LOS of medical comorbidity severe enough to require referral.

MethodsActive medical comorbidity was quantified using referral as the criterion. The study sample consisted of 200 inpatients with the diagnosis of schizophrenia and 228 inpatients suffering from bipolar disorder type I or II. Jonckheere and Mann–Whitney tests were used to estimate the influence of referrals on LOS, and regression analyses isolated variables associated with LOS separately for each group.

ResultsHalf of the patients needed one or more referrals for a non-psychiatric problem. The most common medical condition of patients with bipolar disorder was arterial hypertension. Inpatients with schizophrenia suffered mostly from an endocrine-metabolic disease - 12% of referrals were for Hashimoto’s thyroiditis. A positive linear trend was found between LOS and number of referrals; the effect was greater for schizophrenia patients. The effect of referrals on LOS was verified by regression in both groups. Overall, referred patients showed greater improvement in GAF compared to controls.

ConclusionsTo our knowledge this was the first study to investigate physical comorbidity in psychiatric inpatients using the criterion of referral to medical subspecialties. Comorbidity severe enough to warrant referral is a significant determinant of hospital stay. This insight may prove useful in health care planning. The results show lack of effective community care in the case of schizophrenia and negative symptoms may be the cause of this. Our findings call for more attention to be paid to the general medical needs of inpatients with severe mental health and concurrent severe medical comorbidity.

KeywordsBipolar Schizophrenia Referral Hospital stay Physical comorbidity Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-12-166 contains supplementary material, which is available to authorized users.

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Autor: Athanassios Douzenis - Dionysios Seretis - Stella Nika - Paraskevi Nikolaidou - Athanassia Papadopoulou - Emmanouil N Rizos

Fuente: https://link.springer.com/







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