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The influence of institutional characteristics on length of stay for psychiatric patients: A national database study in South Korea

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  • Chung, Woojin
  • Cho, Woo Hyun
  • Yoon, Chung Won

Abstract

The institutionalization of psychiatric patients has put a tremendous burden on many societies, but few studies have examined the effects of institutional characteristics on patient length of stay (LOS). This paper investigated the association between institutional characteristics and LOS for 160,517 psychiatric patients in South Korea by applying a two-level modeling technique to administrative claims databases covering the entire patient population. Patient LOS, expressed in terms of days, was analyzed by taking account of institutional type, ownership, location, inpatient capacity, staffing, and patient demographics. The characteristics of inpatients were used as control variables and consisted of gender, age, sub-diagnosis, and the type of national health security program. The main findings of this study are: (1) patient LOS was 69% longer at psychiatric hospitals than at tertiary-care hospitals; (2) neither location nor inpatient capacity was associated with LOS; (3) larger staffs reduced LOS; and (4), LOS increased with a higher proportion of male inpatients, inpatients >=65 years old, or inpatients diagnosed with organic or schizophrenic disorders, possibly through contextual effects. The results of this study suggest that researchers and policy makers could improve their assessment of psychiatric patient LOS and its association with health outcome by taking into account institutional characteristics and using multi-level analyses.

Suggested Citation

  • Chung, Woojin & Cho, Woo Hyun & Yoon, Chung Won, 2009. "The influence of institutional characteristics on length of stay for psychiatric patients: A national database study in South Korea," Social Science & Medicine, Elsevier, vol. 68(6), pages 1137-1144, March.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:6:p:1137-1144
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    References listed on IDEAS

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    1. Imai, Hirohisa & Hosomi, Jun & Nakao, Hiroyuki & Tsukino, Hiromasa & Katoh, Takahiko & Itoh, Toshihiro & Yoshida, Takahiko, 2005. "Characteristics of psychiatric hospitals associated with length of stay in Japan," Health Policy, Elsevier, vol. 74(2), pages 115-121, October.
    2. Roggenkamp, Susan D. & White, Kenneth R. & Bazzoli, Gloria J., 2005. "Adoption of hospital case management: economic and institutional influences," Social Science & Medicine, Elsevier, vol. 60(11), pages 2489-2500, June.
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    Cited by:

    1. Woojin Chung & Hoo-Sun Chang & Sun-Min Oh & Chung-Won Yoon, 2013. "Factors associated with long-stay status in patients with schizophrenia: An analysis of national databases covering the entire Korean population," International Journal of Social Psychiatry, , vol. 59(3), pages 207-216, May.
    2. Chung, Woojin & Oh, Sun-Min & Suh, Tongwoo & Lee, Young Moon & Oh, Byoung Hoon & Yoon, Chung-Won, 2010. "Determinants of length of stay for psychiatric inpatients: Analysis of a national database covering the entire Korean elderly population," Health Policy, Elsevier, vol. 94(2), pages 120-128, February.

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