Identifying factors associated with the discharge of male State patients from Weskoppies Hospital.

BACKGROUND

Designated psychiatric facilities are responsible for the care, treatment and reintegration of State patients. The necessary long-term care places a considerable strain on health-care resources. Resource use should be optimised while managing the risks that patients pose to themselves and the community. Identifying unique factors associated with earlier discharge may decrease the length of stay. Factors associated with protracted inpatient care without discharge could identify patients who require early and urgent intervention.

AIM

We identify socio-economic, demographic, psychiatric and charge-related factors associated with the discharge of male State patients.

METHODS

We reviewed the files of discharged and admitted forensic State patients at Weskoppies Psychiatric Hospital. Data were captured in an electronic recording sheet. The association between factors and the outcome measure (discharged vs. admitted) was determined using chi-squared tests and Fischer's exact tests.

RESULTS

Discharged State patients were associated with being a primary caregiver ( = 0.031) having good insight into illness ( = 0.025) or offence ( = 0.005) and having had multiple successful leaves of absences. A lack of substance abuse during admission ( = 0.027), an absence of a diagnosis of substance use disorder ( = 0.013) and the absence of verbal and physical aggression ( = 0.002 and = 0.016) were associated with being discharged. Prolonged total length of stay (9-12 years, = 0.031) and prolonged length of stay in open wards (6-9 years, = 0.000) were associated with being discharged. A history of previous offences ( = 0.022), a diagnosis of substance use disorder ( = 0.023), recent substance abuse ( = 0.018) and a history of physical aggression since admission ( = 0.017) were associated with continued admission.

CONCLUSION

Discharge of State patients is associated with an absence of substance abuse, lack of aggression, multiple successful leave of absences and length of stay in hospital.