Patient Requests for Discharge from Voluntary Psychiatric Hospitalization: a Chart Review

Autor:	Amy S. Aloysi, Jose Martinez, Kaitlyn Larkin, Frank D. Buono, Jacob M. Appel, Amir Garakani
Rok vydání:	2019
Předmět:	Adult Hospitals Psychiatric Male medicine.medical_specialty Adolescent Treatment Refusal Young Adult 03 medical and health sciences Patient Admission 0302 clinical medicine Chart review medicine Humans 030212 general & internal medicine Psychiatry Suicidal ideation Early discharge Aged Retrospective Studies Inpatient care business.industry Public health Middle Aged Patient Acceptance of Health Care Stepwise regression Patient Discharge Confirmatory factor analysis 030227 psychiatry Psychiatry and Mental health Turnover Female New York City medicine.symptom business
Zdroj:	Psychiatric Quarterly. 90:849-859
ISSN:	1573-6709 0033-2720
DOI:	10.1007/s11126-019-09671-y
Popis:	The purpose of this study was to examine the rate of 72-hour letters (written requests for discharge, with 72 hours indicating the time the hospital has to discharge or seek retention) placed by voluntary psychiatric inpatients at a New York City hospital and determine whether there are factors contributing to the rates of discharge requests. Charts from all voluntary psychiatric hospitalizations during the calendar year 2007 were retrospectively reviewed. Included were all single voluntary admissions by adults (age 18 years and older) to the hospital. A confirmatory factor analysis (CFA) was conducted with the following factors: urine toxicology, cigarette use on admission, suicidal ideation upon presentation, employment, past inpatient psychiatric admission, and admission day. A linear regression was used to evaluate the relationship between discharge requests and these factors. Of the total sample (N = 581), 119 (20.5%) patients submitted 72-hour letters. The stepwise linear regression analysis confirmed a positive relationship between letter placement and admission day (M = 3.5, SD = 1.7), unemployment (M = 4.7, SD = 2.1), suicidal ideation (M = .5, SD = .5), positive urine toxicology (M = .47, SD = .5), previous psychiatric hospitalization (M = .7, SD = .5) and cigarette usage (M = .5, SD.5) R2 = .043, (6, 461) = 3.42, p = .003). These specific variables accounted for 55.6% of likelihood of a patient submitting a 72-hour letter. Several factors, related to substance and tobacco use, employment, and recurrent use of inpatient services, likely contribute to requests for early discharge. Addressing these factors may help improve inpatient care, reduce costs and improve patient outcomes in the long term.
Databáze:	OpenAIRE
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