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

Authors
 Woojin Chung  ;  Woo Hyun Cho  ;  Chung Won Yoon 
Citation
 SOCIAL SCIENCE & MEDICINE, Vol.68(6) : 1137-1144, 2009 
Journal Title
 SOCIAL SCIENCE & MEDICINE 
ISSN
 0277-9536 
Issue Date
2009
MeSH
Adolescent ; Adult ; Age Factors ; Aged ; Databases, Factual ; Demography ; Female ; Health Facility Administration* ; Hospitals, Psychiatric/organization & administration ; Humans ; Korea ; Length of Stay/statistics & numerical data* ; Male ; Mental Disorders/therapy* ; Middle Aged ; Ownership ; Personnel Staffing and Scheduling/statistics & numerical data ; Residence Characteristics/statistics & numerical data ; Sex Factors ; Young Adult
Keywords
South Korea ; Length of stay ; Psychiatric care ; Hospital characteristics ; Institutions
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 > or =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
Full Text
http://www.sciencedirect.com/science/article/pii/S0277953608006916
DOI
10.1016/j.socscimed.2008.12.045
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Chung, Woo Jin(정우진) ORCID logo https://orcid.org/0000-0003-2090-4851
Cho, Woo Hyun(조우현)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105833
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