PMID- 8112563
OWN - NLM
STAT- MEDLINE
DCOM- 19940328
LR  - 20190914
IS  - 0163-8343 (Print)
IS  - 0163-8343 (Linking)
VI  - 15
IP  - 6
DP  - 1993 Nov
TI  - Psychiatric length of stay determinants in a military medical center.
PG  - 392-8
AB  - In this 2-year prospective study, 1040 consecutive admissions to an adult 
      inpatient psychiatric unit of the United States Air Force's largest tertiary care 
      medical center were assessed for length of stay (LOS) determinants. Twenty-one 
      demographic, clinical, and diagnostic variables were examined for their effect on 
      LOS. The median LOS at our medical center was 9 days and was similar to the 
      national median LOS of 10 days for psychiatric units in general hospitals. We 
      found several clinical, nonclinical, and diagnostic variables to be independent 
      predictors of LOS, accounting for 31% of the variance, but that much of the 
      variance remained unaccounted for. Primary DSM-III-R discharge diagnoses were 
      helpful in distinguishing a nonoverlapping, short-stay group from a long-stay 
      group. HCFA Diagnostic Related Group (DRG) estimates for LOS were assessed for 
      their ability to predict LOS in our institution. With the exception of substance 
      abuse/dependence disorders, DRGs consistently underestimated LOS. Previous 
      studies using the coefficient of variation (COV) have demonstrated the inability 
      of DRGs to distinguish homogeneous diagnostic groups. However, in this study, COV 
      was helpful in differentiating a majority of DRGs by LOS despite the general 
      underestimation of LOS by DRG. These results continue to support the inadequacy 
      of the DRGs in determining equitable reimbursement and the difficulties in 
      predicting psychiatric LOS despite the inclusion of clinical and nonclinical 
      variables.
FAU - Brock, I P 3rd
AU  - Brock IP 3rd
AD  - Department of Psychiatry, Wilford Hall Medical Center, San Antonio, TX.
FAU - Brown, G R
AU  - Brown GR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Gen Hosp Psychiatry
JT  - General hospital psychiatry
JID - 7905527
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cost-Benefit Analysis
MH  - Diagnosis-Related Groups/economics/statistics & numerical data
MH  - Female
MH  - Hospitals, Military/economics/*statistics & numerical data
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Mental Disorders/economics/psychology/*therapy
MH  - Middle Aged
MH  - Military Personnel/*psychology
MH  - Prospective Studies
MH  - Reimbursement Mechanisms
MH  - Texas
EDAT- 1993/11/01 00:00
MHDA- 1993/11/01 00:01
CRDT- 1993/11/01 00:00
PHST- 1993/11/01 00:00 [pubmed]
PHST- 1993/11/01 00:01 [medline]
PHST- 1993/11/01 00:00 [entrez]
AID - 0163-8343(93)90008-C [pii]
AID - 10.1016/0163-8343(93)90008-c [doi]
PST - ppublish
SO  - Gen Hosp Psychiatry. 1993 Nov;15(6):392-8. doi: 10.1016/0163-8343(93)90008-c.