Factors influencing the length of stay in the psychiatric unit of a Ghanaian teaching hospital: a retrospective study.

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2025-04-07 DOI:10.1007/s00127-025-02889-1

Stephen Wemakor, Kwabena Kusi-Mensah, John-Paul Omuojine, Richard Mensah, Ruth Owusu-Antwi

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引用次数: 0

Abstract

Purpose: The psychiatric length of stay (LOS) in community-based hospital facilities in sub-Saharan Africa reflects the quality of service delivery and the presence of resource challenges. This study aimed to determine the average LOS and identify factors associated with prolonged LOS in the psychiatric unit of a Ghanaian teaching hospital.

Methods: The study analysed 1143 hospital discharge records of psychiatric inpatients at Komfo Anokye Teaching Hospital Psychiatric Unit from January 2016 to October 2020. LOS greater than the median of 10 days was classified as prolonged. We performed multivariable logistic regression to determine factors associated with prolonged LOS.

Results: The mean LOS was 12 days, and the median LOS was 10 days. Bipolar and related disorders (aOR = 1.68 95% CI (1.28-2.21)), substance use disorders (aOR = 1.98 95% CI (1.19-3.30)), co-occurring mental health and substance use disorders (aOR = 2.30 95% CI (1.20-4.56)), and being discharged home directly (aOR = 1.91 95% CI (1.03-3.69)) was associated with a longer hospital stay, while suicide-related behaviour (aOR = 0.27 95% CI (0.09-0.72)) was associated with decreased odds of prolonged hospital stay.

Conclusion: Possible interventions to reduce the length of psychiatric stay in the general hospital setting include improving functional integration of mental health into primary care and implementing transitional treatment programmes like partial hospitalisation and intensive outpatient treatment programmes. Improving access to residential substance use treatment is another intervention that can help decrease the burden of prolonged psychiatric stays.

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影响加纳一家教学医院精神科住院时间的因素：一项回顾性研究。

目的：撒哈拉以南非洲社区医院设施的精神病住院时间（LOS）反映了服务质量和存在的资源挑战。本研究旨在确定加纳一家教学医院精神科患者的平均LOS，并确定与LOS延长相关的因素。方法：对2016年1月至2020年10月Komfo Anokye教学医院精神科住院患者1143例出院记录进行分析。LOS大于10天的中位数被归类为延长。我们进行了多变量逻辑回归来确定与延长的LOS相关的因素。结果：平均生存期为12天，中位生存期为10天。双相及相关障碍（aOR = 1.68 95% CI(1.28-2.21)）、物质使用障碍（aOR = 1.98 95% CI(1.19-3.30)）、同时发生的精神健康和物质使用障碍（aOR = 2.30 95% CI(1.20-4.56)）和直接出院（aOR = 1.91 95% CI(1.03-3.69)）与住院时间延长相关，而自杀相关行为（aOR = 0.27 95% CI(0.09-0.72)）与住院时间延长的几率降低相关。结论：减少综合医院精神病住院时间的可能干预措施包括改善初级保健中心理健康的功能整合，以及实施过渡治疗方案，如部分住院和强化门诊治疗方案。改善住院药物使用治疗的可及性是另一项干预措施，可以帮助减轻长期精神科住院的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.