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Measuring the distribution of the length of stay in acute psychiatric units

Published online by Cambridge University Press:  05 August 2011

Matthew M. Large ,
Michael B. Paton ,
Grant Sara ,
Murray Wright  and
Olav B. Nielssen
Matthew M. Large*
Affiliation:
Psychiatrist and Conjoint Senior Lecturer, School of Psychiatry, University of New South Wales, Sydney, Australia
Michael B. Paton
Affiliation:
Clinical Director, Mental Health Drug and Alcohol, Northern Sydney Local Hospital Network & Central Coast Local Hospital Network, Macquarie Hospital, Sydney, Australia
Grant Sara
Affiliation:
Director, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, North Ryde, Australia Clinical Senior Lecturer, Northern Clinical School, Sydney University, Australia School of Population Health, University of Queensland, Australia
Murray Wright
Affiliation:
Formerly Director, Clinical Operations, Mental Health Drug and Alcohol, Greater Southern Area Health Service, NSW, Australia
Olav B. Nielssen
Affiliation:
Psychiatrist and Conjoint Senior Lecturer, Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia
*
Correspondence to: Matthew Large, The Euroa Building, Prince of Wales Hospital, Barker St, Randwick, New South Wales, Australia, 2031. E-mail: [email protected]
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Abstract

Objective: To examine the distribution of length of stay (LOS) in acute psychiatric units.

Method: Analysis of one year of LOS data from twelve acute psychiatric units in New South Wales, Australia.

Main findings: LOS had a complex distribution, with a ‘head’ of discharges within a day, a ‘body’ of discharges that approximated an exponential distribution and a ‘tail’ made up of a small group of patients discharged after very long admissions. There were substantial differences between units in the proportions of discharges classified as being in the head and the tail of the LOS distribution. With regards to the traditional measures of central tendency, the median LOS was affected by the proportion of patients discharged within a day, and the mean LOS was strongly influenced by small numbers of very long stay patients.

Conclusions: A graphic representation of logarithmically transformed LOS values might assist in understanding the LOS of individual acute psychiatric units. A modified median LOS, calculated after the removal of patients staying less than a day, was found to be a simple and reliable measure that can potentially provide a more meaningful measure of LOS than the mean or the median LOS.

Keywords

Length of staypsychiatric hospital
Type
Original Research Article
Information
Journal of Psychiatric Intensive Care , Volume 8 , Issue 2 , August 2012 , pp. 78 - 87
Copyright
Copyright © NAPICU 2011

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