Prolonged length of stay among individuals presenting to the emergency department with psychosis: Associations with sociodemographic and visit-level characteristics

Abstract

Introduction

Individuals experiencing psychosis commonly initiate and engage in treatment within an emergency department (ED) setting. Understanding factors contributing to adverse ED experiences is critical for improving psychosis-related treatment. Prolonged ED length of stay (LOS), which can be conversely associated with treatment quality, is not well explored among individuals experiencing psychosis.

Methods

In this retrospective analysis of 2129 ED visits for psychosis, we examined sociodemographic characteristics associated with prolonged ED LOS. Among these visits, which occurred from March 1, 2019–February 28, 2021, we also examined the risk of physical restraint, parenteral medication administration, disposition to inpatient psychiatric hospitalization, and substance use positivity by prolonged ED LOS status.

Results

Females, compared to males, were more likely to have prolonged ED LOS; no other sociodemographic characteristics were significantly associated with prolonged ED LOS. Visits with physical restraint, parenteral medication administration, and disposition to inpatient psychiatric hospitalization had a greater risk of prolonged ED LOS compared to visits without these factors.

Conclusions

These findings provide critical insight on approaches to reduce ED LOS among individuals experiencing psychosis and improve treatment engagement.