Length of Stay as a Predictor of Clinical Outcomes in Adolescent Inpatient Psychiatry

Objective Few studies examine the benefit of length of stay (LOS) in inpatient psychiatry. This article examines whether LOS in inpatient psychiatric units contributes to greater clinical outcomes for adolescents.Method This study reviewed charts and patient-reported outcome measures of 315 adolescent admissions on two inpatient psychiatric units at a general children’s hospital. A multiple multivariate linear regression was used to examine the relationship between LOS and patient-reported outcome measures at discharge with admission scores included to control for initial severity. Effect size was measured by partial eta squared (η2p).Results Of the 315 adolescent admissions, 70.8% were assigned female at birth (29.2% male); 41.6% were White, 14.3% were Black or African American, 12.1% were Hispanic/Latino, 4.8% were Asian, and 27.3% reported other race/multiracial background. Ages ranged from 12 to 17 (mean = 14.72; standard deviation = 1.48). LOS was found to have a modest but statistically significant effect on outcomes at discharge (Wilk’s Λ = .951, F [5, 268] = 2.775, p = .019, η2p = .049).Conclusions Although statistically significant, the effect size (η2p = .049) suggests the effect of LOS on patient-reported outcomes is modest. These findings suggest patient-reported outcome measurement throughout admission may be beneficial to identifying rates of patient improvement and whether patients cease improving after reaching a “plateau,” after which stays may not yield additional benefit. Furthermore, a combination of patient-, caregiver- and clinician-reported outcomes may yield more comprehensive data regarding patient improvement and readiness for discharge.