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Length of stay by ICD-based diagnostic groups as basis for the remuneration of psychiatric inpatient care in Switzerland?
Open accessAbstract
Questions under study In an attempt to analyse whether ICD-based diagnostic groups are an appropriate approach to the remuneration of Swiss psychiatric inpatient care, we investigated whether resource consumption in terms of length of stay can be predicted by diagnostic groups as well as by sociodemographic, clinical and admission-specific variables. Methods Data of 30,616 inpatients referred to psychiatric hospitals of a defined catchment area in Switzerland between 1997 and 2003 were analysed. Results The median length of inpatient stay is 23 days, with significant variation between and also within diagnostic groups. Patients with substance-use or adjustment disorders spent the shortest time in inpatient care, while those with an organic or eating disorder remained longest in hospital. Analyses of covariance showed that ICD-based diagnostic groups alone accounted for only 9% of the variance of the logarithmised length of stay. The amount of explained variance was significantly improved by additionally including sociodemographic, clinical and admission-specific variables. Further, investigating interaction terms alongside main effects significantly improved the explained variance to an amount of 20%. Conclusions Diagnostic groups--even if sociodemographic, clinical and admission-specific variables are included--cannot sufficiently predict length of stay to serve as basis for the financial remuneration of Swiss psychiatric inpatient care. These results confirm findings of oth…
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“Associations between LOS and demographic information (e.g., sex, marital status, 76 homelessness) were also noted in several studies but findings are mixed (Averill et al., 77 2001; Cohen and Casimir, 1989; Warnke and Rossler, 2008).”
From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Warnke and Rossler, 2008
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Metadata
- Authors
- Warnke, I., & Rössler, W.
- Affiliations
- Psychiatrische Universitätsklinik Zürich (CH)
- Venue
- Swiss Medical Weekly
- Publisher
- SMW Supporting Association
- Published
- 2008-09-06
- Volume
- 138
- Issue
- 3536
- Pages
- 520-527
- ISSN
- 0036-7672 (ISSN-L)
- 1424-3997
- OpenAlex
- W195270894
- Cited by
- 21
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 2 · 2015: 1 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Swiss Medical Weekly (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- length of hospital stay, psychiatric inpatient care, hospital remuneration, resource consumption, sociodemographic factors, clinical factors, substance use disorders, eating disorders, organic mental disorders, adjustment disorder
- MeSH terms
- Adult, Mental Disorders, Catchment Area, Health, Diagnosis-Related Groups, Female, Humans, Inpatients, Length of Stay, Male, Middle Aged, Psychiatric Department, Hospital, Reimbursement Mechanisms, State Medicine, Switzerland, International Classification of Diseases
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- Warnke, I., & Rössler, W. (2008). Length of stay by ICD-based diagnostic groups as basis for the remuneration of psychiatric inpatient care in Switzerland? Swiss Medical Weekly. https://doi.org/10.4414/smw.2008.12108
