University of Pittsburgh School of Nursing, 3500 Victoria St., Suite 415, Pittsburgh, PA 15213, United States of America.
University of Pittsburgh School of Nursing, United States of America.
Arch Psychiatr Nurs. 2023 Apr;43:106-110. doi: 10.1016/j.apnu.2022.12.001. Epub 2022 Dec 15.
It is well established that Veterans are at increased risk for mental health problems and associated hospitalization. While hospitalization is appropriate for acute stabilization, prolonged stays can contribute to reduced quality of life, increased healthcare expenditures, and trauma exposure with associated trauma-related symptoms. To reduce inpatient psychiatric length of stay and to improve patient outcomes, it is imperative that risk factors for prolonged length of stay are elucidated. The purpose of this retrospective chart review was to examine demographic and clinical characteristics and their association with inpatient psychiatric length of stay in a sample of Veterans. Demographic information collected included age and race. Clinical characteristics collected included primary admitting psychiatric diagnosis, number of psychiatric emergencies during hospitalization, utilization of restraint or seclusion, observation status, 30-day readmission status, adherence to psychiatric follow-up appointments post-discharge, and presence of suicidality. A total of 820 Veterans were included in the analysis. Age, primary psychiatric diagnosis, occurrence of a psychiatric emergency, and observation status were significant predictors of length of stay (F = 24.39, p < .001). There were significant differences in the average length of stay between Veterans with substance use disorders and those with psychotic disorders (B = 0.576, p < .001). Likewise, Veterans with neurocognitive disorders also had longer lengths of stay than those without neurocognitive disorders, respectively (B = 0.014, p < .001). In summary, quality of mental health care can be improved by reducing length of stay, but additional understanding related to risk factors is first needed.
退伍军人心理健康问题和相关住院的风险增加是众所周知的。虽然住院治疗适合急性稳定，但长期住院可能会导致生活质量下降、医疗保健支出增加以及创伤暴露和相关创伤后症状。为了缩短住院精神病患者的住院时间并改善患者的预后，阐明导致住院时间延长的风险因素至关重要。本回顾性图表审查的目的是检查退伍军人样本中的人口统计学和临床特征及其与住院精神病患者住院时间的关联。收集的人口统计学信息包括年龄和种族。收集的临床特征包括主要入院精神科诊断、住院期间发生的精神科急症次数、使用约束或隔离、观察状态、30 天内再入院状态、出院后遵守精神科随访预约情况以及存在自杀意念。共有 820 名退伍军人被纳入分析。年龄、主要精神科诊断、发生精神科急症和观察状态是住院时间的显著预测因素（F=24.39，p<0.001）。有物质使用障碍的退伍军人和有精神病障碍的退伍军人的平均住院时间存在显著差异（B=0.576，p<0.001）。同样，有神经认知障碍的退伍军人的住院时间也长于没有神经认知障碍的退伍军人，分别为（B=0.014，p<0.001）。总之，可以通过缩短住院时间来提高精神卫生保健的质量，但首先需要进一步了解相关风险因素。
