A pilot study on predictors of length of stay in a geriatric psychiatric hospital.

Background: We wanted to determine the factors that influence geriatric psychiatric hospitalization length of stay (LOS).

Methods: We conducted a retrospective cohort study of a sample of hospital admission records from 2012 to 2018. The hospital records were the geriatric inpatient records of St. John's Hospital, Springfield, Illinois. The data collection was based on the inclusion criteria as approved by the Southern Illinois University School of Medicine Institutional Review Board. To be eligible, participants had to have at least 1 inpatient hospitalization between 2012 and 2017. For the purposes of this study, psychiatric diagnosis was based on DSM-IV criteria.

Results: The 141 participants' average age was 71.7 years, and approximately 57% were female; average length of stay was 16 days (range: 1 to 116 days). Indications for current admission included depression and suicidal ideation (45%), psychosis (30%), psychosis and agitation (22%), and mania (3%). Results indicate that having a major depressive disorder (MDD) diagnosis (vs bipolar disorder and schizophrenia) was significantly associated with shorter LOS (P < .001). Other significant predictors were psychosis (P = .03), using mood stabilizers (P = .02), using antidepressants (P = .05), and use of ≥2 (vs 1 or 0) psychotropic medications (P = .02).

Conclusions: Geriatric psychiatric hospitalization was longer in patients with psychosis, but shorter for patients with MDD. Patients receiving mood stabilizers, as well as those receiving ≥2 psychotropics, had longer LOS, while those receiving antidepressants had shorter LOS. This highlights the idea that patients with serious mental illnesses may have longer LOS.