Psychiatric patients: how long do they stay?

Length of stay of acute psychiatric inpatients: an exponential model

We examined the length of stay of inpatients admitted to a psychiatric unit in central London. The commonest length of stay (mode) was less than 1 week. In general, subsequent weeks showed successively fewer discharges, so that the distribution curve of the number of patients by length of stay showed a smooth decline. Analyzing the first 13 weeks of stay, the distribution curve corresponded very closely to a theoretical exponential decay curve. This has implications for recording the average length of stay and thus for comparing one hospital unit with another. It may also have implications for planning for acute psychiatric services. A plea is made for using the median rather than the mean for recording the average length of admission for some purposes.

The nature and effectiveness of general hospital psychiatric services

Inpatient psychiatric episodes in general hospitals represented 58% of the total for the United States by the end of the 1970s. Given this growth, recent studies of the nature and effectiveness of general hospital psychiatric care are reviewed. Surprisingly, the data base continues to be largely descriptive rather than experimental. Evidence is particularly needed about the relative clinical and cost-effectiveness of general hospital treatment vis-a-vis that of other inpatient and community alternatives. Future research must also consider the effect of a general hospital's organizational characteristics upon the manner in which it structures and delivers psychiatric care.