Factors associated with length of stay and readmission in acute psychiatric inpatient services in Portugal.
Abstract
Assessing the factors that influence duration and number of hospitalizations may support mental health services planning and delivery. This study examines the factors associated with length of stay and readmission in Portuguese psychiatric inpatient services during 2002, 2007 and 2012. Data from all admissions were extracted from clinical files. Logistic regression models estimated the association between length of stay (<17 vs ≥17 days) and number of admissions per year (1 vs >1 admission) with sociodemographic, clinical, and contextual factors. Older age, a diagnosis of psychosis, and compulsory admission were associated with higher odds of longer length of stay. Being married, secondary education, suicide attempt, a diagnosis of substance use and "other mental disorders", being admitted in 2012, and two of the psychiatric inpatient services associated with lower odds of longer length of stay. Being retired (or others), a diagnosis of psychosis, compulsory admission, and psychiatric service were associated with increased odds of readmission. Older age, and secondary and higher education were associated with lower odds of readmission. The findings indicate that multiple factors influence length of stay and readmission. Identifying these factors provides useful evidence for clinicians and policy makers to design more targeted and cost-effective interventions.
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Overall readmission was not higher following involuntary admission.
“By contrast, two studies found that overall readmission was not higher following involuntary admission (69,70) although there was an association with involuntary readmission, possibly indicating less therapeutic engagement (71–75).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [69]
Cites
Zhang, J., Harvey, C. A., & Andrew, C. (2011) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048674.2011.585452 · Cited by 212 · see citing works
Length of Stay of General Psychiatric Inpatients in the United States: Systematic Review
Tulloch, A. D., Fearon, P., & David, A. S. (2010) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-010-0310-3 · Cited by 176 · see citing works
Donisi, V., Tedeschi, F., Wahlbeck, K., Haaramo, P., & Amaddeo, F. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-1114-0 · Cited by 166 · see citing works
Lee, S., Rothbard, A. B., & Noll, E. L. (2012) · Psychiatric Services · doi:10.1176/appi.ps.201100412 · Cited by 118 · see citing works
From the asylum to community care: learning from experience
Killaspy, H. T. (2006) · British Medical Bulletin · doi:10.1093/bmb/ldl017 · Cited by 116 · see citing works
Length of hospitalisation for people with severe mental illness
Babalola, O., Görmez, V., Alwan, N. A., Johnstone, P. W., & Sampson, S. J. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000384.pub3 · Cited by 112 · see citing works
Factors Associated with Length of Stay in Psychiatric Inpatient Services in London, UK
Newman, L., Harris, V., Evans, L. J., & Beck, A. (2017) · Psychiatric Quarterly · doi:10.1007/s11126-017-9498-7 · Cited by 96 · see citing works
Impact of economic crises on mental health care: a systematic review
Silva, M., Resurrección, D. M., Antunes, A., Frasquilho, D., & Cardoso, G. (2018) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796018000641 · Cited by 90 · see citing works
Self-citationKalseth, J., Lassemo, E. I., Wahlbeck, K., Haaramo, P., & Magnussen, J. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-1099-8 · Cited by 77 · see citing works
Jacobs, R., Gutacker, N., Mason, A., Goddard, M. K., Gravelle, H. S. E., Kendrick, T., & Gilbody, S. M. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1107-6 · Cited by 70 · see citing works
DETERMINANTS OF INPATIENT PSYCHIATRIC LENGTH OF STAY IN AN URBAN COUNTY HOSPITAL
Compton, M. T., Craw, J. A., & Rudisch, B. E. (2006) · Psychiatric Quarterly · doi:10.1007/s11126-006-9005-z · Cited by 68 · see citing works
What Are the Arguments for Community-Based Mental Health Care?
Mental, S., & Thornicroft, G. (2008) · Cited by 68 · see citing works
Factors associated with length of psychiatric hospitalization
Masters, G. A., Baldessarini, R. J., Öngür, D., & Centorrino, F. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.11.004 · Cited by 64 · see citing works
Predictors of length of stay in a psychiatric hospital
Gopalakrishna, G., Ithman, M., & Malwitz, K. (2015) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2015.1062522 · Cited by 62 · see citing works
Predicting Length of Stay on an Acute Care Medical Psychiatric Inpatient Service
Blais, M. A., Matthews, J., Lipkis‐Orlando, R., Lechner, E., Jacobo, M., Lincoln, R., Gulliver, C., Herman, J. B., & Goodman, A. F. (2003) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1023/a:1026044106172 · Cited by 49 · see citing works
Pauselli, L., Verdolini, N., Bernardini, F., Compton, M. T., & Quartesan, R. (2017) · Psychiatric Quarterly · doi:10.1007/s11126-016-9440-4 · Cited by 49 · see citing works
Werbeloff, N., Chang, C., Broadbent, M. T. M., Hayes, J., Stewart, R. J., & Osborn, D. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30416-3 · Cited by 49 · see citing works
Baeza, F. L., da Rocha, N. S., & Fleck, M. P. (2017) · Revista Brasileira de Psiquiatria · doi:10.1590/1516-4446-2016-2155 · Cited by 46 · see citing works
Stevens, A., Hammer, K., & Buchkremer, G. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00043.x · Cited by 45 · see citing works
Psychiatric readmission: an integrative review of the literature
Machado, V., Leonidas, C., dos Santos, M. A., et al. (2012) · International Nursing Review · doi:10.1111/j.1466-7657.2012.01011.x · Cited by 44 · see citing works
Chung, W., Oh, S.-M., Suh, T., Lee, Y. M., Oh, B. H., & Yoon, C.-W. (2009) · Health Policy · doi:10.1016/j.healthpol.2009.09.004 · Cited by 41 · see citing works
Pertile, R., Donisi, V., Grigoletti, L., Angelozzi, A., Zamengo, G., Zulian, G., & Amaddeo, F. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0231-1 · Cited by 39 · see citing works
Li, X., Srasuebkul, P., Reppermund, S., & Trollor, J. N. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018613 · Cited by 38 · see citing works
Graca, J., Klut, C., Trancas, B., Borja-Santos, N., & Cardoso, G. (2013) · Psychiatric Services · doi:10.1176/appi.ps.000782012 · Cited by 34 · see citing works
Self-citationShinjo, D., Tachimori, H., Sakurai, K., Ohnuma, T., Fujimori, K., & Fushimi, K. (2017) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12521 · Cited by 30 · see citing works
Factors Associated with Length of Stay in a Swiss Mental Hospital
Habermeyer, B., Gennaro, H. D., Frizi, R. C., et al. (2018) · Psychiatric Quarterly · doi:10.1007/s11126-018-9569-4 · Cited by 27 · see citing works
Reforming the Portuguese mental health system: an incentive-based approach
Perelman, J., Chaves, P., Caldas‐de‐Almeida, J. M., & Matias, M. A. (2018) · International Journal of Mental Health Systems · doi:10.1186/s13033-018-0204-4 · Cited by 24 · see citing works
Self-citationLin, H., & Lee, H. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2007.11.011 · Cited by 23 · see citing works
Do patients improve after short psychiatric admission? A cohort study in Italy
Barbato, A., Parabiaghi, A., Panicali, F., Battino, R. N., D’Avanzo, B., de Girolamo, G., Rucci, P., Santone, G., & on behalf of the Progres-Acute Group (2010) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2010.533387 · Cited by 18 · see citing works
Lin, C.-E., Chung, C.-H., Chen, L.-F., Chen, P.-C., Cheng, H.-Y., & Chien, W.-C. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-018-1606-y · Cited by 18 · see citing works
Siskind, D. J., Harris, M., Diminic, S., Carstensen, G., Robinson, G., & Whiteford, H. (2014) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867414543566 · Cited by 15 · see citing works
Volpe, F. M., Braga, I. P., & da Silva, E. M. (2018) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2017-0080 · Cited by 7 · see citing works
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The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review
Corderoy, A., Kisely, S., Zirnsak, T., & Ryan, C. J. (2025) · Psychiatry, Psychology and Law · doi:10.1080/13218719.2024.2346734 · Cited by 19 · see citing works
“By contrast, two studies found that overall readmission was not higher following involuntary admission (69,70) although there was an association with involuntary readmission, possibly indicating less therapeutic engagement (71 – 75).”
Castelpietra, G., Guadagno, S., Pischiutta, L., Tossut, D., Maso, E., Albert, U., & Balestrieri, M. (2022) · Journal of Public Health Research · doi:10.4081/jphr.2021.2382 · Cited by 2 · see citing works
- Authors
- Silva, M., Antunes, A., Loureiro, A., Azeredo-Lopes, S., Saraceno, B., Caldas-de-Almeida, J., & Cardoso, G.
- Affiliations
- Lisbon Institute of Global Mental Health (PT)
- Centro de Estudos em Geografia e Ordenamento do Territorio (PT)
- Corresponding author
- Silva, M
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 293
- Pages
- 113420
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W3079706848
- Cited by
- 24
- References
- 32
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 1 · 2022: 6 · 2021: 1
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fundação para a Ciência e a Tecnologia
- Universidade de Coimbra (PTDC / ATP - GEO / 4101 / 2012)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- length of hospital stay, hospital readmission, psychiatric inpatient care, involuntary admission, psychosis, suicide attempts, substance use disorders, sociodemographic factors, mental health service planning, Portugal
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Mental Disorders, Educational Status, Female, Hospitalization, Hospitals, Psychiatric, Humans, Inpatients, Length of Stay, Male, Mental Health Services, Middle Aged, Patient Readmission, Portugal, Retrospective Studies, Young Adult
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