Factors affecting prolonged length of stay in psychiatric patients in Japan: A retrospective observational study
Abstract
Aim: Hospital length of stay (LOS) is one of the stratified measures of health‐care efficiency and is commonly used to assess performance of psychiatric care. The aim of this study was to identify risk factors for prolonged LOS of psychiatric patients. Methods: We retrospectively analyzed adult psychiatric patients (ICD‐10; F00–F99) between April 2012 and March 2014 in the Japanese Diagnosis Procedure Combination database. We examined factors affecting prolonged LOS using multivariable logistic regression analysis. Subgroup analyses of the logistic regression were undertaken according to two diagnostic groups (F20–F29 and F30–F39). Results: A total of 34 326 patients admitted to and discharged from psychiatric beds were included. Older age, lower Global Assessment of Functioning score, involuntary commitment, several psychiatric services, certain other patient factors, academic hospitals, public hospitals, and higher density of psychiatric beds were significantly associated with prolonged LOS. Hospital patient volume was significantly associated with shorter LOS. In the subgroup analyses, most of these factors were consistent although some were not associated with prolonged LOS. Conclusion: Not only clinical factors but also institutional characteristics were associated with prolonged LOS. Our study provided useful information for improvement in psychiatric services and indicated the need to consider the division of roles between healthcare/welfare institutions and psychiatric‐related resource allocation. Interventions should be considered for achieving shorter LOS for psychiatric patients.
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Two papers found that involuntary treatment reduced carer satisfaction.
“Two papers found that involuntary treatment reduced carer satisfaction (107,124), while one found no difference in satisfaction between carers of voluntary or involuntary patients (29) and another no association with legal status and perceived carer burden (125).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [124]
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- Authors
- Shinjo, D., Tachimori, H., Sakurai, K., Ohnuma, T., Fujimori, K., & Fushimi, K.
- Affiliations
- University of Tokyo Hospital (JP)
- National Center of Neurology and Psychiatry (JP)
- Tokyo Medical and Dental University (JP)
- Tohoku University (JP)
- Corresponding author
- Fushimi, Kiyohide
- Venue
- Psychiatry and Clinical Neurosciences
- Publisher
- Wiley
- Published
- 2017-05-10
- Volume
- 71
- Issue
- 8
- Pages
- 542-553
- ISSN
- 1323-1316 (ISSN-L)
- 1440-1819
- OpenAlex
- W2601712197
- Cited by
- 30
- References
- 28
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2022: 4 · 2021: 2 · 2020: 7 · 2019: 2 · 2018: 6
- FWCI
- 5.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry and Clinical Neurosciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (16K19284)
- Ministry of Health, Labour and Welfare (H28‐Seisaku‐Shitei‐009)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Keywords
- risk factors, psychiatric inpatients, involuntary admission, Global Assessment of Functioning, academic medical centers, public hospitals, institutional characteristics, mental health services, resource allocation, Japan
- MeSH terms
- Adolescent, Adult, Aged, Female, Hospitalization, Hospitals, Psychiatric, Humans, Japan, Length of Stay, Male, Middle Aged, Retrospective Studies, Risk Factors, Databases, Factual, Young Adult
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