Predicting the length of hospital stay of psychiatry patients using signal detection analysis

• Published in: Psychiatry research Vol. 210; no. 3; pp. 1211 - 1218
• Main Authors: Badriah, Fase, Abe, Takeru, Nabeshima, Yoshihiro, Ikeda, Kouji, Kuroda, Kenji, Hagihara, Akihito
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 30.12.2013; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Hospitals, Psychiatric - utilization; Humans; Institution therapy. Inpatient treatment; Japan; Length of Stay - statistics & numerical data; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - rehabilitation; Middle Aged; Outcome; Patient Admission - statistics & numerical data; Patients; Prediction; Predictive Value of Tests; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Signal detection analysis; Signal Detection, Psychological; Treatments; Young Adult; Asia; Japan; Outcome; Prediction; Signal detection analysis; Social environment; Human; Psychiatric hospital; Signal detection theory; Residence time; Mental health; Epidemiology; Treatment; Follow up study; Mental disorder; Public health
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2013.09.019

Abstract In Japan, the length of hospital stay (LOS) at psychiatric institutions often exceeds a year, and factors related to such stays have been identified. However, we do not know how multiple patient, hospital, and physician factors interact to determine LOS. Patient data were collected from a psychiatric hospital in Osaka, Japan. We developed subgroups, which were determined by interactions related to LOS using signal detection theory. In acute or emergency wards, five factors related to LOS were identified, and subjects were categorized into six subgroups. The indices obtained by the five factors ranged 2.49–3.47 for odds ratio, 0.47–0.84 for sensitivity, 0.40–0.76 for specificity, and 0.52–0.71 for positive predictive value. In general wards, five factors related to LOS were identified, and subjects were categorized into six subgroups. The indices obtained by the five factors ranged 3.02–5.36 for odds ratio, 0.58–0.86 for sensitivity, 0.37–0.68 for specificity, and 0.85–0.92 for positive predictive value. Psychiatrists who have been practicing longer in acute or emergency wards appear to have significantly longer stay of patients, and older or more severe patients tend to be in need of longer inpatient care. Our results provide findings that may be helpful in decreasing LOS at psychiatric hospitals.