Fekete Szabolcs, Girasek Hunor, Ungvari Gabor S, Gazdag Gábor
National Institute of Forensic Psychiatry, Budapest, Hungary.
Semmelweis University, Doctoral College, Budapest, Hungary.
Front Psychiatry. 2025 May 13;16:1582702. doi: 10.3389/fpsyt.2025.1582702. eCollection 2025.
In recent years, the length of stay (LoS) in forensic psychiatric inpatient institutions has been increasing worldwide. Although an excessive LoS constitutes a human rights violation, the underlying reasons and associated factors have not been fully established, and differences between countries and regions have led to limited conclusive information.
This retrospective study used data from a nationally representative sample of 301 adult patients who were admitted to the National Institute of Forensic Psychiatry, Hungary's only forensic inpatient psychiatric institution, following a court-issued compulsory treatment order for reason of insanity during 2000-2015 to investigate the demographic, clinical, and criminal offense-related factors associated with inpatient LoS.
Among the variables found to be significant in univariate analyses, a multiple regression model with bootstrapping confirmed significant associations of LoS with the type and method of the index criminal offense, community residential setting into which the patient was released, age and gender (all p < 0.05). However, the regression model accounted for only 34.1% of the observed variance in LoS, suggesting the presence of additional unexplored factors that may lead to excessive LoS.
The Hungarian forensic psychiatric system should implement a more evidence-based method for determining the LoS for inpatient care.
近年来，全球范围内法医精神病住院机构的住院时间（LoS）一直在增加。尽管过长的住院时间构成了对人权的侵犯，但其根本原因和相关因素尚未完全明确，而且国家和地区之间的差异导致确凿信息有限。
这项回顾性研究使用了来自匈牙利唯一的法医住院精神病机构——国家法医精神病研究所的全国代表性样本数据，该样本包含301名成年患者，他们在2000年至2015年期间因精神错乱被法院下达强制治疗令后入院，以调查与住院时间相关的人口统计学、临床和刑事犯罪相关因素。
在单变量分析中发现显著的变量中，采用自抽样法的多元回归模型证实住院时间与索引刑事犯罪的类型和方法、患者出院后的社区居住环境、年龄和性别均存在显著关联（所有p<0.05）。然而，回归模型仅解释了观察到的住院时间方差的34.1%，这表明存在其他未探索的因素可能导致住院时间过长。
匈牙利法医精神病系统应采用更基于证据的方法来确定住院护理的住院时间。
